The Simple Truth About Gluten and Endometriosis in 2024

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Does it seem like there is a not-so-mysterious relationship between gluten and symptoms of endometriosis? So many sources promote a gluten free diet for healing from chronic illness including endometriosis and you may have thrown out every bag of flour and crumb of pastry in an effort to heal holistically. But does it actually work? What is all of the fuss about gluten when so many healthy looking people eat all the glutenous wheat they want without ill effect? (Allegedly at least, right?)

Let’s get to the bottom of the gluten free claim for healing an endometriosis ravaged body. What’s the truth?

I share my favorite gluten alternatives at the end…

What’s the Truth About Gluten and Endometriosis?

There are a few threads to unravel when it comes to this question because the answer includes various nuances. There are several truths to consider in this question and determining if you should go or stay gluten free to feel better.

For one, America’s non-organic wheat supply is largely GMO and uses pesticides in its production. This rather cheap grain is then processed and sent to your local supermarket where it may be stored in the shelves for an unknown period of time. In the meantime, the flour could become rancid causing various physical symptoms. If you can get a clean wheat berries and then ground them into wheat flour (Einkorn is amazing but fairly hard to come by these days) then perhaps your symptoms would be lessened. Pesticides are a known endocrine disrupting chemical (EDS) that can wreak havoc on your body. This is a negative for most people concerned about gluten and endometriosis.

Coupled by the change in growing and harvesting practices when compared to the more ancient times is the way the harvested grains are made ready for consumption. Grains were traditionally prepared through fermentation. This allowed for the rather hard to digest grain to begin the digestion process outside of the body. After consumption, your body would continue the digestion process.

Plus, the bodies of the past (think even further back) weren’t corrupted by the onslaught of processed foods and the destructiveness of those products on the modern man’s gut flora. In other words, when bread was a key staple of the diet such as in the days of the bible people’s bodies processed the grains much differently than you or I do today.

In fact, wheat was such an important staple and 70% of the West’s prebiotics come from wheat. So, wheat has been an important dietary staple for a myriad of reasons including that our microbiome relied upon it so heavily.

Another idea to think about is that most refined carbohydrates are simple starches and simple starches are converted to glucose immediately after ingestion. From there it becomes sugar and acts as any other sugar in the body. You can read more about why it’s a good idea to break up with sugar for your endometriosis. In a nutshell, sugar and sugar mimicking foods cause hormone imbalance, disrupt the endocrine system, changes your brain biochemistry into one of an addict and can lead to a host of health troubles down the road.

Refined carbohydrates can lead to a host of issues related to gut dysbiosis, leaky gut, bloating and many other issues that harm your immune system. Another negative point for the gluten and endometriosis connection.

Though, wheat berries traditionally were grown, harvested, ground and used for fermenting and baking. Whole wheat is a bit different than wheat with all of the nutrients and fiber removed.

There also seems to be a spectrum of disease associated with gluten issues, from celiac disease and celiac ataxia on the more severe end of the spectrum and gluten allergy or gluten intolerance being on the more manageable end of the spectrum. Research also points to a strange connection between endometriosis and celiac disease. In this case, a woman in the study experienced infertility which came from her undiagnosed celiac disease more so than her endometriosis. Once she switched to a gluten free diet she became pregnant.

Those experiencing gluten sensitivity have a proclivity towards immune dysfunction. The study found that those who do have a gluten sensitivity are more likely to have gut dysbiosis (leaky gut) and low grade intestinal inflammation along with immune dysfunction.

When I dive into the research on the connections between gluten and endometriosis, it’s hard to miss the seeming connection between endometriosis and gluten. In one study, women who had period pain went on a gluten free diet for a year and 75% of those in this group reported a statistically significant improvement of menstrual pain.

Did you know that wheat in the field can also be sprayed with hormones to get it to grow better (faster, fatter, etc.)? These hormones certainly interact with and disrupt your own hormones. The connection between gluten and hormone imbalance is well documented in the PubMed (published medicine) database – almost 400 peer reviewed research articles in fact. Check out this video highlighting this gluten and endometriosis hormone imbalance connection.

gluten and hormone disruption

If you have endometriosis then you have immune issues. If you want to improve your symptoms I would recommend taking a sensitivity tests or blood tests and cut gluten out of your life. (It takes three months for gluten to leave your body so make sure you eliminate it for at least 3 months to start noticing changes.)

If you have infertility that is unexplained you may want to cut gluten out of your diet. Gluten does not affect everyone in the same way and some of you may have no issues with gluten (yet) and it is probably less important for you than say not getting enough essential fatty acids in your diet but it will be very important for many of you. Overall I hope you now see a connection between gluten and endometriosis.

Men can also have gluten intolerance that can lead to infertility.

Do you have gluten sensitivity?

If you have wondered whether or not you have issues with gluten you can check out this link to take a gluten sensitivity test online at the Gluten Free Society’s website. Many people with immune issues report feeling better when they remove gluten from their diets and I personally feel much better going gluten free. It may be an option to consider for the management of painful endometriosis and/or as a strategy for management of painful periods. But what if you really want to know before starting a strict gluten and endometriosis diet? What if you really need to know? Then it is definitely worth assessing how gluten affects you.

The Best Alternatives for a GlutenFree Diet

What are you to do when you switch to a gluten free lifestyle? It’s time to start experimenting with the best wheat alternatives for your baking and cooking needs. While I occasionally do miss a good homemade wheat biscuit with butter, I find myself missing whole foods, fruits, vegetables, meats, fish and other starches and grains. The world accommodates the gluten free diet so well these days and there are so many options. Lucky for us looking to avoid gluten and endometriosis symptoms.

It can feel hard when first making the switch. Your taste buds need time to acclimate. You need time to experiment in the kitchen and you need to acclimate your grocery shopping and budget to making the change. While I used to prioritize those gluten free snacks in a box to reward myself after a long day, these days I batch cook and meal prep mostly all from scratch. This helps to eliminate my need to a quick processed food snack which was very expensive and didn’t taste super amazing.

Note: While you can purchase gluten free flours in their own bag, it has been found that it is more nutritious to mix your own. That’s what I do. That way you ensure there aren’t any flours or additives you didn’t want in the first place which are cheaper and a filler. Buy your gluten subs to use on their own or mix your own blends, my two cents. 🙂

Here are my favorite gluten substitutions:

(1) Cassava Flour by Terrasoul Superfoods (Organic)

gluten free flour


Cassava flour cannot be underrated. It is a dietary staple in Africa and Southeast Asia and has become more mainstream in the US (but I still meet plenty of people who have never heard of it.) It is a starchy carbohydrate with a slightly nutty flavor. I love it and use it occasionally for gluten free pizza crust, gluten free spice crackers, as a substitute when making biscuits and cowboy casserole and for baking cookies. It has become my number one substitute for wheat in the kitchen. I buy it in bulk to get lower overall costs.

My one caution is that it is high in carbs and it is a processed carb so eating it often can spike your blood sugar. Like all wheat substitutes, still use prudence and don’t overdo it, okay?


  • Great cooking and baking substitute from regular wheat
  • Nice flavor
  • A nice compliment for the pantry when going gluten free


Cassava flour is so versatile that I’ve started using it as a substitute for everything calling for wheat. I do limit carbs and favor vegetables, protein and fats, and use my cassava flour as a well needed treat. Use it how your will and make note to watch your blood sugars when eating any processed flour. I would also recommend using arrowroot with the cassava flour in your homemade pizza crust. Definitely worth using for avoiding gluten and endometriosis symptoms.

(2) Arrowroot Powder by Nova Nutritions (Organic)


Arrowroot is a plant-based powder that contains many nutrients including iron, folate, B6, phosphorus and potassium. It has a little bit more protein than cassava flour and is a helpful low glycemic food meaning it won’t raise your blood sugars quite as much as cassava flour might. It is used as a thickener and can be combined with other gluten free flours or in soups and stews. I love how versatile this powder is in my kitchen.


  • Gluten free
  • Good mineral and nutrient content
  • A low glycemic index food
  • A little goes a long way and your product will last you

Bottom Line

This is an important staple in my gluten free kitchen and helps me avoid gluten and endometriosis symptoms. I love how a little goes a long way and how I am able to buy a bit batch that will last me about a year. It is also one of the easiest starch flours for the body to digest.

(3) Coconut Flour by Vivanaturals (Organic)


Coconut flour is a delicious addition to your gluten free pantry. It is one of the many ways to include coconut into your diet apart from coconut oil, milk, sugar, aminos and cream. Coconut products help support a healthy metabolism. One of the benefits of coconut flour is that it is also on the low glycemic index for foods which means that it doesn’t convert into sugars as rapidly as say wheat flour or cassava flour. This is a positive when you are trying to avoid blood sugar dysregulation which can be harmful for hormone balance.

Finally, coconut products are MUFAs, or monounsaturated fatty acids which provide a host of health benefits and which the body synthesizes naturally but benefits from good food sources. Another reason to avoid gluten and endometriosis symptoms. I wrote a whole post about the importance of essential fatty acids and good quality monounsaturated fatty acids (MUFAs).


  • Gluten free
  • Delicious for making gf deserts and baked goods
  • Supports a healthy metabolism
  • Low on the glycemic index (good for blood sugar regulation)
  • Quality MUFA source

Bottom Line

As far as gluten and endometriosis are concerned, substituting with coconut flour is a no-brainer. It does usually require a bit more liquid in baking recipes because it tends to soak up moisture quickly but when done right it is a delicious alternative to wheat.

(4) Almond Flour by Blue Diamond


Almond flour is one of the most popular gluten free alternatives out there and like coconut flour its original substance provides for an array of exciting products. You may have heard of them (kind of joking here, unless you have been living under a rock): almond milk, butter, flour, almond extract and almond joy (had to throw that in there).

Almonds are high in vitamin e, a healthy source of fatty acids, lipids, amino acids, proteins, carbs, vitamins and minerals. They can be helpful for those with type II diabetes by improving blood sugar levels and body mass index. Sounds like another great alternative to gluten and endometriosis stagnation.


  • Gluten free
  • Healthy source of fatty acids, lipids, amino acids, proteins, carbs, vitamins and minerals
  • Helpful with blood sugar regulation
  • Helpful with body mass index

Bottom Line

Almond flour is one of the first alternatives to gluten I used for baking, and it is another wonderful staple for your pantry. It is nutritious, tasty and it made my transition away from gluten SO EASY!

Other alternatives

These days, it is simple and easy to find good alternatives to gluten. Gluten and endometriosis don’t need to go together to the party any longer! Some of my other top recommendations include:

  • Chickpea Flour
  • Amaranth Flour
  • Buckwheat Flour
  • Teff Flour (wonderful for PMS symptoms)
  • Tigernut Flour

Prebiotics and Wheat

While going gluten free may be helpful for people with endometriosis, it’s important to realize that 70% of the Western diet’s prebiotics come from wheat according to Dr. Tom O’Bryan. When wheat is removed, other prebiotic foods should be added.

What are some examples of prebiotics?

  • Artichokes
  • Onions
  • Carrots
  • Parsnips
  • Turnips
  • Rutabega
  • Potato


If you have issues with gluten and endometriosis or infertility symptoms I hope you found this post helpful. While everybody is different when it comes to gluten insensitivity, allergy, celiac disease or without issue, it is still worth knowing about some of that research, eh? If you want to make informed decisions about your health, then you need to know what the true research shows not what worked for that one person a friend knows or a doctor who hasn’t researched the issue himself or herself.

There are a host of reasons to start going gluten free such as improved immune system function, more balanced hormones, less gut inflammation, and less leaky gut type symptoms. These are some of the main symptoms that gluten and endometriosis may have in common. Of course, if you have period pain, research shows that in studies where women gave up gluten for 12 months (the length of time used in the study) had a statistically significant improvement in menstrual pain. Yeah! Kick that pain to the curb!

These days there are many ways to make easy substitutes with gluten alternatives. These alternatives to gluten and endometriosis improvements may blow your mind! While they make take some getting used, if you are already used to the subs then don’t ya think they’re pretty easy? Would love your feedback in the comments section!

Author’s Note: Thanks for reading! I personally use and support the products featured above. Occasionally, I recommend products I genuinely love and will earn commissions as an Amazon Affiliate if you decide to make a purchase through the links at no cost to you. Posts like these allow me to keep A Pain in the Endo’s content free.

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