Endometriosis and dysbiosis: State of art

Brunella Zizolfi, Virginia Foreste, Alessandra Gallo, Simona Martone, Peirluigi Giampaolino, Attilio Di Spiezio Sardo
Frontiers in endocrinology · 2023 · vol. 14 , pp. 1140774 · doi:10.3389/fendo.2023.1140774 · PMID:36891056 · W4321375859
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review summarizes the literature on the relationship between gut microbiota dysbiosis and endometriosis, exploring potential mechanisms like bacterial contamination, immune activation, and altered hormone metabolism.

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

This narrative review examined the literature on whether dysbiosis and altered microbiota relate to endometriosis, using a MEDLINE and Web of Science search focused on keywords including endometriosis and dysbiosis and including observational studies, case-control studies, and relevant reviews; it explicitly excludes non-English work, conference papers, and overlapping publications unless they add new information. Across reviewed human and animal studies, the paper reports associations between endometriosis and shifts such as reduced Lactobacillus dominance and increased abundance of multiple pathogenic taxa in the cervix or other genital sites, higher microbial diversity within ectopic lesions, and gut microbiota changes in mouse models. Mechanistic hypotheses summarized include bacterial contamination/endotoxin-driven immune activation (e.g., LPS–TLR4 pathways), impaired cytokine regulation and immunosurveillance, and downstream effects on inflammation and estrogen-related pathways, while also noting that consensus on genital-tract microbiota remains limited and the evidence is heterogeneous. This paper is centrally about endometriosis — it summarizes the state of research linking dysbiosis and microbiota alterations to endometriosis pathogenesis.

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Abstract

Endometriosis is a complex and heterogeneous disease affecting approximately 10% of reproductive age women. The hypothesis that alterations in the microbiota are involved in the pathogenesis of endometriosis has been postulated. Possible explanations for the implications of dysbiosis in endometriosis include the Bacterial Contamination hypothesis and immune activation, cytokine-impaired gut function, altered estrogen metabolism and signaling. Thus, dysbiosis, disrupt normal immune function, leading to the elevation of proinflammatory cytokines, compromised immunosurveillance and altered immune cell profiles, all of which may contribute to the pathogenesis of endometriosis. The aim of this review is to summarize the available literature data about the relationship between microbiota and endometriosis.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Gastrointestinal Microbiome Gastrointestinal Microbiome Gastrointestinal Microbiome Gastrointestinal Microbiome Gastrointestinal Microbiome Gastrointestinal Microbiome Gastrointestinal Microbiome Gastrointestinal Microbiome Gastrointestinal Microbiome Microbiota Microbiota

Citation neighborhood

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.

References (67)

Cited by (16)

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