Role of the gut microbiota in the pathogenesis of endometriosis: a review

Cuishan Guo, Chiyuan Zhang
Frontiers in microbiology · 2024 · vol. 15 , pp. 1363455 · doi:10.3389/fmicb.2024.1363455 · PMID:38505548 · PMC10948423 · W4392467305
review OA: gold CC0 ⤵ 16 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review discusses how the gut microbiota's involvement in inflammation, estrogen metabolism, and immunity contributes to the development and progression of endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This review examines how gut microbiota may contribute to endometriosis pathogenesis by influencing inflammation, estrogen metabolism, immunity, and related mechanisms, drawing on human and animal evidence including microbiota profiling and microbiota-depletion models. It summarizes reported findings of gut dysbiosis in endometriosis across several studies, such as altered abundances and ratios of taxa (e.g., Lactobacilli, Bacteroidetes/Firmicutes) and effects of transferring fecal microbiota or depleting microbiota on ectopic lesion growth, while noting that results across studies are not fully consistent. A key limitation explicitly raised is that differences in animal sources, modeling methods, feeding conditions, and sampling time may explain conflicting outcomes and timing of observed dysbiosis. This paper is centrally about endometriosis — it reviews mechanisms linking gut microbiota composition and function to endometriosis development and progression.

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Abstract

Endometriosis is classically defined as a chronic inflammatory heterogeneous disorder occurring in any part of the body, characterized by estrogen-driven periodic bleeding, proliferation, and fibrosis of ectopic endometrial glands and stroma outside the uterus. Endometriosis can take overwhelmingly serious damage to the structure and function of multi-organ, even impair whole-body systems, resulting in severe dysmenorrhea, chronic pelvic pain, infertility, fatigue and depression in 5-10% women of reproductive age. Precisely because of a huge deficiency of cognition about underlying etiology and complex pathogenesis of the debilitating disease, early diagnosis and treatment modalities with relatively minor side effects become bottlenecks in endometriosis. Thus, endometriosis warrants deeper exploration and expanded investigation in pathogenesis. The gut microbiota plays a significant role in chronic diseases in humans by acting as an important participant and regulator in the metabolism and immunity of the body. Increasingly, studies have shown that the gut microbiota is closely related to inflammation, estrogen metabolism, and immunity resulting in the development and progression of endometriosis. In this review, we discuss the diverse mechanisms of endometriosis closely related to the gut microbiota in order to provide new approaches for deeper exploration and expanded investigation for endometriosis on prevention, early diagnosis and treatment.

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Condition tags

endometriosischronic_pelvic_paindysmenorrheainfertility

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.

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