Endometriosis and weight gain: What’s the link?

By Zawn Villines 

Reviewed by Holly Ernst, PA-C

Weight gain | Symptoms | How to
lose weight | Endometriosis and PCOS | Summary

Endometriosis causes
endometrial tissue, which usually lines the uterus, to develop outside of the
uterus. It can cause chronic pain, heavy or irregular periods, and infertility.
Some people also report weight gain and bloating.

Little research has explored
why endometriosis might cause weight gain. People with endometriosis who
suspect that the condition is causing weight gain or making it difficult for
them to lose weight should speak to a doctor.
Sometimes, other conditions
such as polycystic ovary syndrome (PCOS) can mimic the symptoms of
In this article, we look at
how endometriosis may cause weight gain and explore how to achieve and maintain
a healthy weight.
Does endometriosis cause
weight gain?

While plenty of anecdotal
evidence has linked endometriosis to weight gain, scientific research does not
yet back this up.
Qualitative research from 2014
found that some women feel that endometriosis contributes to weight gain and
poor body image.
There are at least four ways
in which endometriosis might cause weight gain.

Bloating and fluid retention
are common endometriosis symptoms. While bloating does not cause the body to
gain fat, it can make a person look and feel heavier.
Bloating may also change the
way that clothing fits. Many people notice that bloating is worse immediately
before or during their period.

Endometriosis is an
estrogen-dependent disease, which means that the symptoms worsen with higher
estrogen levels.
Some people believe that
estrogen dominance causes weight gain. This happens when the body produces too
much estrogen, outweighing the progesterone.
Drugs to treat endometriosis

Many studies show that
endometriosis treatments may cause weight gain.
One of the most effective
treatments for endometriosis is a synthetic form of the hormone progesterone.
Progesterone slows the growth of endometrial tissue.
However, many women experience
weight gain with progesterone. According to a 2010 study, 40–50 percent of
women gain weight or retain water with progesterone treatment.


Endometriosis is painful. For
some people, the pain is severe enough to make it difficult to exercise and
stay active. Over time, this can cause weight gain.
Symptoms of endometriosis

A few endometriosis symptoms
can make a person look or feel heavier. These symptoms may include:

  • bloating
  • constipation
  • fluid retention
  • masses of endometrial tissue
    in the pelvic region
Other symptoms of
endometriosis can include:

  • severe cramping during periods
  • pelvic pain between periods
  • pain during sex
  • difficulty getting pregnant
  • bladder pain
  • strong urges to urinate
  • incontinence
  • pain during bowel movements or
  • unexplained pain in the
The severity of the symptoms
does not necessarily indicate how extensive the endometriosis adhesions are.
Some people with severe endometriosis have no symptoms. People with mild
endometriosis may have severe symptoms.
How to lose weight with

Many natural and alternative
health websites promise to help people with endometriosis lose weight with
special diets. However, there is no clinical evidence to suggest that an
endometriosis-specific diet can help with weight gain or reduce endometriosis
Having surgery to remove
endometrial tissue that is growing outside of the uterus can help with pain and
may reduce bloating. This, in turn, may help a person lose weight or look
To lose weight in any
situation, a person must burn more calories than they consume. Some strategies
that can support this goal include:

  • Increasing physical activity.
    Walk as often as possible and take regular breaks from long periods of sitting.
    The Physical Activity Guidelines for Americans 2015–2020 advise getting 150–300
    minutes of moderate-intensity cardio or 75–150 minutes of high-intensity cardio
    each week. They also advise strength training on at least 2 days per week.
  • Eating a variety of filling,
    lower-calorie foods.
    Avoiding excess sugary snacks, sodas, and other sweetened
    drinks can also help.
  • Eating more protein. Protein
    may improve metabolism and help a person feel fuller for longer. This reduces
    the desire to eat high-calorie snacks.
People with endometriosis
should talk to a doctor about weight loss strategies, especially if they have
other conditions such as PCOS.
Endometriosis and PCOS

PCOS has some similar symptoms
to endometriosis. PCOS occurs due to a hormone imbalance and, like
endometriosis, can cause painful periods.
Other symptoms of PCOS

  • irregular or absent periods
  • excessive body hair
  • unexplained weight gain
  • difficulty getting pregnant
  • insulin resistance or diabetes
It is possible for people with
endometriosis to also have PCOS. For this reason, it is important for people
with irregular periods, painful periods, or fertility issues to seek testing for
both conditions.
PCOS can cause weight gain,
often due to insulin resistance. A low-glycemic index diet may help with
PCOS-related weight gain. Some people also find that hormonal birth control
pills help with symptoms.

Endometriosis is a chronic
condition. However, a number of management strategies, including hormone
treatments and surgery, can help with symptoms.
Many women with endometriosis
feel frustrated that there is little research available about
endometriosis-related weight gain. A doctor who listens and takes a person’s
symptoms seriously is the key to finding an effective treatment.
By talking to their doctors
about weight gain, people can get personalized weight loss strategies and
support for the challenges of living with endometriosis.

Kayode Ojo
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.