Endometriosis – is there consensus on a role for the gut microbiome?

Endometriosis – is there consensus on a role for the gut microbiome?

Reading: Endometriosis – is there consensus on a role for the gut microbiome? 2 minutes

At present, there is no conclusive evidence regarding the role of the gut microbiome in endometriosis. 

A systematic review concluded that there are differences in microbiome composition of individuals with and without endometriosis (e.g. increased levels of Proteobacteria, Enterobacteriaceae, Streptococcus spp. and Escherichia coli in endometriosis). However, of the eighteen included in the review, only 6 had studied the gut microbiome, and only one study had investigated the human gut microbiome. 

A cross-sectional study in women with and without endometriosis (n=264) suggested that the gut microbiome may be altered in women with endometriosis, with significant differences at genus level for a number of bacteria. In this study, it was not possible to conclude whether the gut microbiome impacted endometriosis or whether endometriosis impacted the gut microbiome.

While the role of the gut microbiome in endometriosis remains unclear, studies to date suggest it may be implicated in development and progression. Additionally, given the emerging research on the estrobolome, and the fact that endometriosis is considered highly oestrogen-dependent, further research exploring the link between this condition and the role of the gut microbiome in hormone regulation is required.

Finally, it has been reported that women with endometriosis are three times more likely to have IBS compared with women without endometriosis. In these scenarios, evidence-based can support with symptom management.


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  2. Svensson A, Brunkwall L, Roth B, Orho-Melander M, Ohlsson B. Associations Between Endometriosis and Gut Microbiota. Reprod Sci. 2021 Aug;28(8):2367-2377. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289757/
  1. Chandni Talwar, Vertika Singh, Ramakrishna Kommagani, The gut microbiota: a double-edged sword in endometriosis, Biology of Reproduction, Volume 107, Issue 4, October 2022, Pages 881–901, https://doi.org/10.1093/biolre/ioac147
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