Current Updates on the Role of Microbiome in Endometriosis: A Narrative Review

Hooi‐Leng Ser; Siu-Jung Au Yong; Mohamad Nasir Shafiee; Norfilza Mohd Mokhtar; Raja Affendi Raja Ali

doi:10.3390/microorganisms11020360

Current Updates on the Role of Microbiome in Endometriosis: A Narrative Review

Hooi‐Leng Ser, Siu-Jung Au Yong, Mohamad Nasir Shafiee, Norfilza Mohd Mokhtar, Raja Affendi Raja Ali

Microorganisms · 2023 · vol. 11(2) , pp. 360 · doi:10.3390/microorganisms11020360 · PMID:36838325 · W4318777451

review OA: gold CC0 ⤵ 30 in-corpus citations

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

This review explores how gut and urogenital microbiome imbalances may contribute to endometriosis pathogenesis and suggests that microbiome research could inform new treatment strategies and diagnostic biomarkers.

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Abstract

Endometriosis affects approximately 6 to 10% of reproductive-age women globally. Despite much effort invested, the pathogenesis that promotes the development, as well as the progression of this chronic inflammatory disease, is poorly understood. The imbalance in the microbiome or dysbiosis has been implicated in a variety of human diseases, especially the gut microbiome. In the case of endometriosis, emerging evidence suggests that there may be urogenital-gastrointestinal crosstalk that leads to the development of endometriosis. Researchers may now exploit important information from microbiome studies to design endometriosis treatment strategies and disease biomarkers with the use of advanced molecular technologies and increased computational capacity. Future studies into the functional profile of the microbiome would greatly assist in the development of microbiome-based therapies to alleviate endometriosis symptoms and improve the quality of life of women suffering from endometriosis.

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[1] A 10-Year Study of Endometriosis in an Indigenous Black African Population via openalex

[2] A Clinical and Pathologic Exploration of Suspected Peritoneal Endometriotic Lesions via openalex

[3] A higher prevalence of endometriosis among Asian women does not contribute to poorer IVF outcomes via openalex

[4] Alpha‐linolenic acid regulates the gut microbiota and the inflammatory environment in a mouse model of endometriosis via openalex

[5] Altered Composition of Microbiota in Women with Ovarian Endometrioma: Microbiome Analyses of Extracellular Vesicles in the Peritoneal Fluid via openalex

[6] A More Diverse Cervical Microbiome Associates with Better Clinical Outcomes in Patients with Endometriosis: A Pilot Study via openalex

[7] An evidence‐based approach to assessing surgical versus clinical diagnosis of symptomatic endometriosis via openalex

[8] Animal models for research on endometriosis via openalex

[9] Antibiotic Therapy and Vaginal Microbiota Transplantation Reduce Endometriosis Disease Progression in Female Mice via NF-κB Signaling Pathway via openalex

[10] Antibiotic therapy with metronidazole reduces endometriosis disease progression in mice: a potential role for gut microbiota via openalex

[11] A Review of the Prevalence of Endometriosis in African Women via openalex

[12] Aromatase and other steroidogenic genes in endometriosis: translational aspects via openalex

[13] Association of microbial dynamics with urinary estrogens and estrogen metabolites in patients with endometriosis via openalex

[14] Associations Between Endometriosis and Gut Microbiota via openalex

[15] A systematic review of the accuracy of ultrasound in the diagnosis of endometriosis via openalex

[16] A two-arm parallel double-blind randomised controlled pilot trial of the efficacy of Omega-3 polyunsaturated fatty acids for the treatment of women with endometriosis-associated pain (PurFECT1) via openalex

[17] Bacterial contamination hypothesis: a new concept in endometriosis via openalex

[18] Can symptomatology help in the diagnosis of endometriosis? Findings from a national case–control study—Part 1 via openalex

[19] Chronic Pelvic Pain in Women via openalex

[20] Correction: Accuracy of transvaginal sonography versus magnetic resonance imaging in the diagnosis of rectosigmoid endometriosis: Systematic review and meta-analysis via openalex

[21] Correction: A two-arm parallel double-blind randomised controlled pilot trial of the efficacy of Omega-3 polyunsaturated fatty acids for the treatment of women with endometriosis-associated pain (PurFECT1) via openalex

[22] Correlation of fecal metabolomics and gut microbiota in mice with endometriosis via openalex

[23] Current situation of menstruation and gynecological diseases prevalence among Chinese women: a cross-sectional study via openalex

[24] Developing symptom-based predictive models of endometriosis as a clinical screening tool: results from a multicenter study via openalex

[25] Diagnosis and management of endometriosis: summary of NICE guidance via openalex

[26] Diagnostic accuracy of physical examination, transvaginal sonography, rectal endoscopic sonography, and magnetic resonance imaging to diagnose deep infiltrating endometriosis via openalex

[27] Diagnostic accuracy of transvaginal sonography for deep pelvic endometriosis via openalex

[28] Diagnostic accuracy of transvaginal sonography for detecting parametrial involvement in women with deep endometriosis: systematic review and meta‐analysis via openalex

[29] Diagnostic accuracy of transvaginal ultrasound for detection of endometriosis using International Deep Endometriosis Analysis (<scp>IDEA</scp>) approach: prospective international pilot study via openalex

[30] Disparity in endometriosis diagnoses between racial/ethnic groups via openalex

[31] Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review via openalex

[32] Effects of endometriosis on immunity and mucosal microbial community dynamics in female olive baboons via openalex

[33] Effects of<i>Lactobacillus gasseri</i>OLL2809 on the Induced Endometriosis in Rats via openalex

[34] Endometrial microbiota is more diverse in people with endometriosis than symptomatic controls via openalex

[35] Endometriosis via openalex

[36] Endometriosis Classification, Staging and Reporting Systems: A Review on the Road to a Universally Accepted Endometriosis Classification via openalex

[37] Endometriosis: Epidemiology, Diagnosis and Clinical Management via openalex

[38] Endometriosis induces gut microbiota alterations in mice via openalex

[39] Endometriosis in Menopause—Renewed Attention on a Controversial Disease via openalex

[40] Endometriosis Pathoetiology and Pathophysiology: Roles of Vitamin A, Estrogen, Immunity, Adipocytes, Gut Microbiome and Melatonergic Pathway on Mitochondria Regulation via openalex

[41] Endometriosis prevalence and incidence trends in a large population-based study in Catalonia (Spain) from 2009 to 2018 via openalex

[42] Epidemiologic factors associated with endometriosis in East Asia via openalex

[43] Escherichia coli contamination of menstrual blood and effect of bacterial endotoxin on endometriosis via openalex

[44] ESHRE guideline for the diagnosis and treatment of endometriosis via openalex

[45] Gonadotrophin-releasing hormone analogues for pain associated with endometriosis via openalex

[46] Gut Microbiota Exceeds Cervical Microbiota for Early Diagnosis of Endometriosis via openalex

[47] IDDF2021-ABS-0132 Moving beyond the gastrointestinal tract: the involvement of gut microbiome in endometriosis via openalex

[48] Imaging modalities for the non-invasive diagnosis of endometriosis via openalex

[49] Incidence of endometriosis among Japanese women. via openalex

[50] Inflammation and nerve fiber interaction in endometriotic pain via openalex

[51] Influence of race/ethnicity on prevalence and presentation of endometriosis: a systematic review and meta‐analysis via openalex

[52] Interleukin-15 and Interleukin-7 are the Major Cytokines to Maintain Endometriosis via openalex

[53] Intra-uterine microbial colonization and occurrence of endometritis in women with endometriosis† via openalex

[54] Intricate Connections between the Microbiota and Endometriosis via openalex

[55] Lactobacillus gasseri OLL2809 inhibits development of ectopic endometrial cell in peritoneal cavity via activation of NK cells in a murine endometriosis model via openalex

[56] Lactobacillus gasseri OLL2809 is effective especially on the menstrual pain and dysmenorrhea in endometriosis patients: randomized, double-blind, placebo-controlled study via openalex

[57] Laparoscopic surgery for endometriosis via openalex

[58] Laparoscopic surgery for endometriosis via openalex

[59] Long-term trends in the incidence of endometriosis in China from 1990 to 2019: a joinpoint and age–period–cohort analysis via openalex

[60] Malignant Transformation of Postmenopausal Endometriosis: A Systematic Review of the Literature via openalex

[61] Medical Treatments for Endometriosis-Associated Pelvic Pain via openalex

[62] Metastatic or Embolic Endometriosis, due to the Menstrual Dissemination of Endometrial Tissue into the Venous Circulation. via openalex

[63] Microbiome analysis in women with endometriosis: Does a microbiome exist in peritoneal fluid and ovarian cystic fluid? via openalex

[64] Microbiome of the lower genital tract in Chinese women with endometriosis by 16s-rRNA sequencing technique: a pilot study via openalex

[65] Microbiome Profile of Deep Endometriosis Patients: Comparison of Vaginal Fluid, Endometrium and Lesion via openalex

[66] Microbiota composition and distribution along the female reproductive tract of women with endometriosis via openalex

[67] Molecular detection of intrauterine microbial colonization in women with endometriosis via openalex

[68] Molecular detection of microbial colonization in cervical mucus of women with and without endometriosis via openalex

[69] Not Having Been Breastfed May Protect Chinese Women From Developing Deep Infiltrating Endometriosis: Results From Subgroup Analyses of the FEELING Study via openalex

[70] Pathogenesis and pathophysiology of endometriosis via openalex

[71] Pathophysiology and Immune Dysfunction in Endometriosis via openalex

[72] Pathophysiology of endometriosis-associated pain: A review of pelvic and central nervous system mechanisms via openalex

[73] Pathophysiology of pain in patients with peritoneal endometriosis via openalex

[74] Postmenopausal endometriosis, where are we now? via openalex

[75] Prevalence and incidence of endometriosis in Australian women: a data linkage cohort study via openalex

[76] Prevalence and Symptomatic Burden of Diagnosed Endometriosis in the United States: National Estimates from a Cross-Sectional Survey of 59,411 Women via openalex

[77] Prevalence of endometriosis in women undergoing surgery for benign gynecologic diseases. via openalex

[78] Prevalence, Symptomatic Burden, and Diagnosis of Endometriosis in Canada: Cross-Sectional Survey of 30 000 Women via openalex

[79] Relugolix, an oral gonadotropin-releasing hormone receptor antagonist, reduces endometriosis-associated pain in a dose–response manner: a randomized, double-blind, placebo-controlled study via openalex

[80] REVIEW ARTICLE: Immunopathogenesis of Pelvic Endometriosis: Role of Hepatocyte Growth Factor, Macrophages and Ovarian Steroids via openalex

[81] Risk Profiles for Endometriosis in Japanese Women: Results From a Repeated Survey of Self-Reports via openalex

[82] Sonovaginography is a new technique for assessing rectovaginal endometriosis via openalex

[83] Symptomatic endometriosis developing several years after menopause in the absence of increased circulating estrogen concentrations: a systematic review and seven case reports via openalex

[84] Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group via openalex

[85] Th1 and Th2 immune responses related to pelvic endometriosis via openalex

[86] Thai Interest Group for Endometriosis (TIGE) consensus statement on endometriosis-associated pain via openalex

[87] The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis via openalex

[88] The Effect of Surgical Intervention of Endometriosis to CA-125 and Pain via openalex

[89] The effects of nutrients on symptoms in women with endometriosis: a systematic review via openalex

[90] The Endobiota Study: Comparison of Vaginal, Cervical and Gut Microbiota Between Women with Stage 3/4 Endometriosis and Healthy Controls via openalex

[91] The link between immunity, autoimmunity and endometriosis: a literature update via openalex

[92] Theories on the Pathogenesis of Endometriosis via openalex

[93] The role of the vaginal microbiome in distinguishing female chronic pelvic pain caused by endometriosis/adenomyosis via openalex

[94] Translational animal models for endometriosis research: a long and windy road via openalex

[95] Treatment of endometriosis: a review with comparison of 8 guidelines via openalex

[96] Treatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist via openalex

[97] Treatment of endometriosis-associated pain with linzagolix, an oral gonadotropin-releasing hormone–antagonist: a randomized clinical trial via openalex

[98] Treg and NK cells related cytokines are associated with deep rectosigmoid endometriosis and clinical symptoms related to the disease via openalex

[99] Validation study of nonsurgical diagnosis of endometriosis via openalex

[100] W7033435514 via openalex