Food and dietary supplement expenditures associated with dietary self-management among women with endometriosis: A cross-sectional study in Hungary

Objective To compare the financial burden of special diets and dietary supplement use in women with and without endometriosis. Methods This cross-sectional, mobile health app–based survey in Hungary (December 2023–August 2024; 90% response rate) evaluated 1645 women aged 14–45 years (524 with endometriosis, 1121 without). Primary outcomes were monthly household food and individual supplement expenditures. Secondary outcomes included diet adherence and supplement use. Results Women with endometriosis, particularly those following special diets, reported significantly higher food and supplement spending than reference participants ( p < 0.01). Despite smaller households (mean 2.49 vs. 2.95 persons, p < 0.01), more spent over €400/month on food than in the reference group (30% vs. 24%; median €301–€400 vs. €251–€300). Women with endometriosis were more than twice as likely to report supplement costs exceeding €35/month (22% vs. 9%; median €16–€25 vs. €6–€15; p < 0.01). Diet adherence and supplement use were also significantly higher ( p < 0.01). After controlling for relevant sociodemographic characteristics, endometriosis status remained significantly associated with food expenditure (B = −0.19, β = −0.08, p = 0.02) and supplement expenditure (B = −0.52, β = −0.2, p < 0.01). Conclusions Endometriosis is associated with greater financial burden from dietary self-management. These findings highlight the need for evidence-based nutritional guidance and consideration of economic impact in care.