Impact of Gut and Reproductive Tract Microbiota on Estrogen Metabolism in Endometriosis

The incidence of endometriosis is rising, particularly among younger populations, yet current diagnostic and therapeutic approaches remain limited. This highlights the urgent need for novel diagnostic tools and effective treatments. Recent studies have shown that intestinal and reproductive tract bacterial dysbiosis is closely associated with the development of endometriosis and plays a key role in the regulation of estrogen metabolism.

This review aims to provide a comprehensive overview of the mechanisms of the microbiota's role in regulating estrogen levels and influencing the development and progression of endometriosis, providing important insights into the diagnosis and management of the disease.

Microbial changes not only promote estrogen imbalance by regulating β-glucuronidase activity, but also respond to estrogen imbalance by affecting the expression of metabolites such as short-chain fatty acids and lipopolysaccharides. In addition, significant fluctuations in estrogen levels also affect the composition of the microbial community. Both factors jointly lead to changes in the immune microenvironment of endometriosis. Conflicts of Interest The authors declare that no conflict of interest is reported in this paper. Data Availability Statement Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

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