Endometriosis: Epigenetics, Diet and Future Directions

Endometriosis: Epigenetics, Diet and Future Directions

Understanding Endometriosis and Epigenetics

Endometriosis, a common yet often debilitating condition affects millions of women worldwide. It’s characterized by the growth of endometrial-like tissue outside the uterus, leading to pain and infertility. The exact cause of endometriosis remains a subject of ongoing research, but recent studies have increasingly pointed towards epigenetics as a key factor. In the molecular age of research this is going to lead to answers and treatments beyond just hormonal management and surgery, the cornerstones of today’s treatment.

Epigenetics refers to changes in gene activity and expression that don’t involve alterations to the underlying DNA sequence. One of the primary mechanisms of epigenetic change is DNA methylation, where methyl groups are added to the DNA molecule, often changing the activity of a DNA segment without changing the sequence.

The Role of Methylation in Endometriosis

DNA methylation plays a crucial role in regulating gene expression. In endometriosis, abnormal methylation patterns have been observed. For instance, hypomethylation (decreased methylation) in certain genes may lead to their overexpression, contributing to the disease’s progression.

A recent study titled “Hypomethylation of the ENPP3 promoter region contributes to the occurrence and development of ovarian endometriosis via the AKT/mTOR/4EBP1 signaling pathway” explores the epigenetic factors in endometriosis, focusing on the ENPP3 gene. This research is pivotal in understanding how epigenetic changes, like DNA methylation, can influence endometriosis and suggests possible therapeutic strategies. It also highlights the role of diet and nutrients, such as folate, in these epigenetic processes. For the full study follow this link to PubMed.

Diet and Epigenetic Changes

Diet plays a significant role in epigenetic modifications. Nutrients can directly impact the methylation process. Folate, for instance, is crucial for the production of methyl groups used in DNA methylation. This connection suggests that dietary choices could influence epigenetic markers associated with diseases like endometriosis.

Dietary Implications for Endometriosis Management

Considering the epigenetic involvement in endometriosis, dietary interventions might offer a complementary approach to management. Diets rich in methyl donors like folate could potentially influence methylation patterns and thus impact the progression of endometriosis. Foods high in folate include leafy greens, fruits, nuts, and whole grains.

Treatment Implications

Understanding the epigenetic mechanisms in endometriosis opens new avenues for treatment. Epigenetic therapy, which involves modifying these epigenetic changes, could become an important part of managing the disease. This could include drugs that affect methylation patterns or use of targeted dietary interventions.

Future Directions and Research

Further research is needed to fully understand the relationship between diet, epigenetics, and endometriosis. Personalized dietary plans based on individual epigenetic profiles might become a reality in the future.


The connection between endometriosis, epigenetics, and methylation highlights the complexity of the disease and opens up new possibilities for its management. The impact of diet and nutrients like folate on these epigenetic changes underscores the potential of a holistic approach to treatment, combining medical interventions with lifestyle and dietary modifications.


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“I help and guide women to beat endometriosis and gynecologic cancers that are associated with endo, like ovarian cancer, using a unique combination of minimally invasive robotic surgery, precision medicine therapies and complementary holistic natural support towards thriving in survivorship." Dr. Vasilev is the only physician triple board certified in Ob-Gyn, Gynecologic Oncology and Integrative & Holistic Medicine in the United States. He is an accomplished advanced robotic master surgeon, and is internationally vetted by iCareBetter (https://icarebetter.com/doctor/dr-steven-vasilev/). He serves as Professor at the world-renowned Saint John's Cancer Institute in Santa Monica, California and is Clinical Professor at Loma Linda University School of Medicine. He is former faculty and professor at UC Irvine, UCLA, USC and City of Hope and was the founding Medical Director of Integrative Medicine at Providence Saint John's Health Center. He is an active member of multiple medical societies and has been nationally listed in "Best Doctors" for over 20 years.