The role of microbiota in the pathophysiology of uterine fibroids – a systematic review

Lidia Korczynska, Natalia Żeber‐Lubecka, Magdalena Zgliczyńska, Elżbieta Zarychta, Kornelia Zaręba, Cezary Wojtyła, Michalina Dąbrowska, Michał Ciebiera
In: Frontiers in Cellular and Infection Microbiology · 2023 · vol. 13 , pp. 1177366 · doi:10.3389/fcimb.2023.1177366 · PMID:37305407 · W4378386666
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This systematic review found that gut microbiota dysbiosis may be a risk factor for uterine fibroids, with altered bacterial populations detected in patients with the condition.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This systematic review examined how intestinal and uterine dysbiosis relate to uterine fibroids by searching MEDLINE/PubMed, Scopus, and Cochrane (search completed January 26, 2023) and including 16 original human studies that assessed uterine microbiome criteria. Across included studies, the authors report evidence of altered bacterial composition in patients with uterine fibroids, including changes in fecal taxa such as Firmicutes, Proteobacteria, Actinobacteria, and Verrucomicrobia, and they describe pilot findings suggesting differences in uterine cavity diversity and lower presence of Lactobacillus with fibroids in some datasets. The review emphasizes that conventional culture-based methods are limited because many bacteria are hard to grow, and it notes that current human and animal data remain limited and inconsistent, requiring more intensive future studies. Relevance to endometriosis: the paper cites prior work linking microbiome imbalance to conditions including endometriosis (e.g., He et al., 2021; Qi et al., 2021), though its main focus is uterine fibroids and uterine/intestinal microbiome associations rather than endometriosis directly.

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Abstract

For a long time, the uterus had been considered a sterile organ, meaning that under physiological conditions the uterus would not be colonized by bacteria. Based on available data, it may be concluded that the gut and uterine microbiome are related, and that the role of this microbiome is greater than expected. Despite being the most common pelvic neoplasms in women of reproductive age, uterine fibroids (UFs) are still poorly understood tumors whose etiology has not been fully determined. This systematic review presents the relationship between intestinal and uterine dysbiosis and uterine fibroids. A systematic review of three medical databases was carried out: the MEDLINE/PubMed, Scopus and Cochrane. In this study, 195 titles and abstracts were reviewed, including only original articles and clinical trials of uterine microbiome criteria. Finally, 16 studies were included to the analysis. In recent years, researchers dealing with reproduction in a broad sense have focused on the microbiome in various locations to study its role in the pathogenesis and, consequently, the prevention and treatment of diseases of the genital organ. Conventional microbial detection methods are not suitable for identifying bacteria, which are difficult to culture. Next-generation sequencing (NGS) provides an easier and faster and more informative analysis of bacterial populations. It seems that gut microbiota dysbiosis has the potential to be a risk factor for uterine fibroids or affect the disease process. Some changes were shown in many types of bacteria, such as Firmicutes, Proteobacteria, Actinobacteria and Verrucomicrobia detected in fecal samples in patients with uterine fibroids. In view of the few results on the link between the microbiome and uterine fibroids, further intensive studies in humans and animal models are necessary, including the possible use of different microbiome modulations in the prevention or treatment of uterine fibroids.

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