Nutritional Counseling for Endometriosis: An Interview with Nicole Heinze

Nutritional counseling can provide valuable support for endometriosis.

Meet Nicole Heinze, a research associate at Hannover Medical School (MHH) and a self-employed nutritionist specializing in women’s health. With a focus on the impact of nutrition on endometriosis, she is a knowledgeable resource for discussing the role of nutritional counseling in managing this condition.

What sparked your interest in the field of nutrition for endometriosis?

Nicole: I delved into the realm of nutrition counseling eight years ago and pursued a master’s degree in health sciences afterward. My entry into the field of endometriosis and nutrition was influenced by my lecturer and current colleague, Dr. Iris Brandes. I was eager to collaborate with her on my master’s thesis, and while her focus was on endometriosis, mine was centered around nutrition. The two topics seamlessly converged, shaping the trajectory of my research and professional journey.

What is the current status of research on nutrition and endometriosis?

Nicole: The state of research on nutrition and endometriosis is currently somewhat limited. While research is underway in a few locations globally, much of it relies on anecdotal evidence.

Testimonials from women who find certain approaches helpful are valuable, especially when research is in its early stages. However, relying solely on anecdotal evidence is generally insufficient to make accurate statements about what practices are advisable or not.

Research is exploring various directions, but often there is not enough comprehensive investigation into each aspect. For instance, there might be two studies on vitamin D or gluten-free nutrition, but if these studies contradict each other or differ in quality, it can cloud the overall message. As such, the state of research in this area is still evolving and has room for expansion.

Of the available insights, could you share the top three findings with us?


Point 1: Nutrition has a significant impact on endometriosis, offering the potential to alter, reduce, and improve symptoms.

Point 2: Achieving these changes is possible through a regular diet; supplements are unnecessary unless a deficiency has been confirmed by a doctor or blood test, and there is no additional goal such as fertility alongside managing endometriosis.

Point 3: Given the unique nature of endometriosis, diet must be highly individualized. Each person presents with distinct symptoms, varying locations of endometriosis, and different stages of the condition. Additionally, endometriosis often coexists with food intolerances, allergies or cross-allergies, necessitating an individualized approach. Collaboration between nutritionists and patients is crucial for success; otherwise, in my view, it may not be effective.

Eating healthily is beneficial, but self-care is essential. Are there any UNIVERSALLY applicable restrictions, or is it more nuanced?

Nicole: There are no fixed rules when it comes to eating. It is essential to consider each person individually. Maintaining a healthy diet is a positive step for now.

What misconceptions exist? Have you come across information about endometriosis that is false or only partially accurate?

Nicole: There is not a single definitive book on nutritional advice for endometriosis; there are several out there. However, the notion of a one-size-fits-all diet for the condition is a myth. Due to the diversity among women, there cannot be a singular diet that benefits everyone. This holds true in everyday life and extends to managing endometriosis.

Additionally, broad statements like, “You have cramps, why do you not take magnesium?” can be problematic. Cramps can be linked to factors beyond magnesium deficiency, such as inadequate water intake or a lack of potassium.

There is an abundance of statements circulating about regular nutrition alone, some of which are questionable. They could be based on a single study, even when 25 other studies suggest otherwise. It is crucial to approach such information with skepticism. However, it does not discount the value of women affected by endometriosis sharing what has helped them. Collecting this information to evaluate what truly works would be more beneficial. This approach helps dispel myths and provides more reliable guidelines.

Ultimately, with all recommendations, paying attention to what individually proves helpful is vital.

Let us delve into specific individual experiences often shared in testimonials, such as the contentious issue of milk. Opinions on dairy products and their relationship to endometriosis can be quite polarized.

Nicole: Dairy products are a widely discussed topic overall. From my research, I have not found evidence supporting either the advantages or disadvantages of avoiding or consuming dairy products in relation to endometriosis. A study from 2004 found no significant correlation between dairy consumption and endometriosis. However, there are recommendations in certain books to avoid it. Conversely, another review suggests that consuming probiotic foods, including dairy, may be beneficial.

The current state of knowledge lacks clear-cut statements; both perspectives are advocated. In my view, the best approach is to consider the individual woman and her intuition. Does she feel that milk is beneficial for her?

Where can one access nutritional counseling for endometriosis?

Individual nutrition counselors often specialize in women’s health, but there are very few who specifically focus on endometriosis and nutrition.
Earlier this year, I launched my own business in response to the limited availability of such services. My research has provided extensive insights into nutrition for endometriosis, but it became evident during my university research work that practical experience was essential.

The demand for scientifically based nutritional advice exists, and engaging in practical consultations allows me to observe firsthand the challenges individuals face. This mutual exchange benefits both the practice and my ongoing research efforts.

Previously, when asked for recommendations on nutrition counselling for endometriosis, I struggled to identify suitable practitioners.

Where exactly can you be located?

Nicole: You can currently visit my website at: I also have an Instagram account where you will find information about my courses on women’s health, including current offerings related to childbearing, pregnancy, and breastfeeding. Additionally, I will be introducing an endometriosis nutrition course. You are welcome to reach out and connect with me online. If you are looking for in-person consultations, you can find me at the gynecologist’s office in the real world.

What is the typical procedure for nutritional counseling for endometriosis?

Nicole: The process is individualized. I typically start with an introductory meeting to gauge compatibility and determine if we are aligned for future sessions, which can span two months or longer. Regular follow-up appointments help assess progress. Given the personal nature of nutrition, I craft an individual roadmap for subsequent sessions for everyone.

If there are no pre-existing conditions, sessions may be covered by health insurance. I am currently in the process of obtaining certification for health insurance reimbursement.

For individuals with endometriosis, the process differs. They must provide a doctor’s letter approving nutrition coaching, and the nutrition counselor also needs a specific licensing for this. Otherwise, the expense may need to be paid out of pocket (as is currently the case with me). I am optimistic that this will change in the future, allowing me to offer support for endometriosis through health insurance.

Is there a final takeaway message you would like to share?

Nicole: If you are considering nutritional counseling, make sure to educate yourself.

It is beneficial to seek guidance from professionals experienced in dealing with rheumatoid arthritis, celiac disease, and/or food intolerances. This expertise is valuable as nutritional counseling for endometriosis should be anti-inflammatory, and intolerances often play a role. Knowledge of inflammatory conditions is essential.

Look for someone who is a member of a professional association, ensuring they have received proper training. You can also obtain a list of nutritionists from your health insurance company (e.g., VDOE, VDD, DGE, BfD).  These individuals can settle the financial matters with insurance, guaranteeing you access to qualified nutritionists who understand their field.

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Dr. med. Nadine Rohloff