Pathological Interaction Mechanisms between Cervical Mycoplasma and Chlamydia Infections and Endometriosis: Novel Clinical Management Strategies

Zhaodong Wei, Cunjian Yi
In: Journal of Biosciences and Medicines · 2025 · vol. 13(11) , pp. 209–225 · doi:10.4236/jbm.2025.1311015 · W4416098501
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review explores the dynamic interaction between cervical mycoplasma/chlamydia infections and endometriosis, proposing a "dual-track treatment" strategy that integrates hormone therapy, anti-infectives, and immune-microbiome modulation for precision prevention and treatment.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This narrative review examines epidemiological characteristics, molecular pathogenesis, and proposed clinical management strategies linking endometriosis with cervical Mycoplasma and Chlamydia infections, synthesizing evidence on inflammatory signaling, immune dysregulation, and reproductive-tract microbiome imbalance. The paper reports that chronic pelvic inflammation from ectopic endometrial tissue (e.g., IL-1β, TNF-α, IL-6) can promote a cycle of “infection–inflammation–ectopic progression,” and it describes how infection-related barrier disruption and innate immune activation may intersect with endometriosis mechanisms such as progesterone resistance and estrogen-driven inflammatory pathways; it also highlights associations with altered microbiome diversity, including increased proportions of Ureaplasma urealyticum and Chlamydia trachomatis. A stated limitation is that, despite synthesizing prior findings, the direct mechanistic link between these specific cervical infections and endometriosis remains incompletely understood and the clinical strategy is presented as a proposed framework rather than validated by new trials in this article. This paper is centrally about endometriosis — it focuses on a proposed pathological interaction model between cervical Mycoplasma/Chlamydia infections and endometriosis progression and management.

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Abstract

Endometriosis (EMs), a prevalent chronic inflammatory disease among women of reproductive age, has a global prevalence of 10% - 15% and is closely associated with 30% - 50% of infertility cases. This review systematically examines the epidemiological characteristics and molecular pathogenesis of EMs, establishing for the first time a dynamic interaction model between cervical mycoplasma and chlamydia infections in the pathological progression of EMs. Based on epidemiological correlation analysis, it reveals the spatiotemporal association between genital tract infections and EMs onset. By examining inflammatory pathway interactions, immune dysregulation, and microbiome imbalance, it elucidates the potential infection-inflammation-endometriosis “pathological vicious cycle”. Clinically, it innovatively proposes a “dual-track treatment” strategy integrating targeted hormone therapy, precision anti-infective regimens, and combined immune-microbiome modulation. This review constructs a precision prevention and treatment system through a translational medicine perspective. It not only achieves a paradigm shift in diagnosis and treatment from “symptom control” to “etiological intervention” but also provides EM patients with personalized treatment pathways based on molecular subtyping. This breakthrough offers a novel methodological framework for addressing treatment resistance and recurrence prevention in EM.

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Condition tags

endometriosisinfertility

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