Relationship between the gut microbiome and endometriosis and its role in pathogenesis, diagnosis, and treatment: a systematic review

Isabella M. Weber, Isabella Weber, Anna Sienko, A Urbán, Carolyn Szwed, Krzysztof Czajkowski, Pawel Basta, Paweł Basta, Jacek Sieńko
Ginekologia polska · 2023 · vol. 95(11) , pp. 893–901 · doi:10.5603/gpl.97581 · PMID:37772919 · W4387133488
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This systematic review of 16 studies found that patients with endometriosis exhibit an altered gut microbiome, which may offer insights into pathogenesis, diagnostic markers, and therapeutic approaches.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This systematic review evaluated the gut microbiome’s role in endometriosis pathogenesis, diagnosis, and treatment by searching Embase, Medline, and PubMed (English, June 2013–June 2023) for studies matching endometrios*/adenomyos* and gut microbiome/dysbiosis terms, following PRISMA procedures. Across included case-control and experimental animal and human studies using approaches such as 16S rRNA gene sequencing, the reviewed findings reported gut microbiome differences between people with endometriosis and controls (e.g., altered taxa and diversity, and in mice shifts in Firmicutes/Bacteroidetes) and linked interventions such as broad-spectrum antibiotics, probiotics, n-butyrate, or specific metabolites to changes in endometriotic lesion outcomes in animal models. A major limitation explicitly reflected by the heterogeneity of study designs and biomarkers summarized in Table 1 is that results span multiple populations, sampling sites, and analytical methods, complicating direct synthesis. This paper is centrally about endometriosis — it systematically reviews evidence linking the gut microbiome to endometriosis-related pathogenesis, diagnostic possibilities, and treatment approaches.

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Abstract

Endometriosis is a chronic inflammatory disease affecting approximately 10% of women. It is defined as endometrial tissue outside of the uterus and produces a variety of symptoms including pelvic pain, dysmenorrhea, dyspareunia, and intermenstrual bleeding. Although several theories have been postulated regarding the pathogenesis of endometriosis, no theory has provided a complete explanation, therefore limiting our progress in diagnostic tools and management of endometriosis. Recently, much attention has been paid to the importance and role of the gut microbiome in endometriosis. As defined by Joshua Lederberg - microbiome is a set of the genome of microorganisms inhabiting a human body, including commensal, symbiotic and pathogenic microorganisms. The aim of this systematic review was to conduct a search in the Embase, Medline, and PubMed databases for literature from July 2013 to July 2023 regarding the relationship between the gut microbiome and endometriosis. 147 records were screened, of which 26 met the eligibility criteria, and 16 were included in this review. Our review concludes that patients with endometriosis show an altered gut microbiome, and that this has the potential to provide insight for pathogenesis, markers for diagnosis, as well as therapeutic options for treatment of endometriosis. Future research is necessary to confirm this and further investigate the relationship between the gut microbiome and endometriosis.

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Condition tags

endometriosisdysmenorrheadyspareunia

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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