The role of gut microbiota in modulating estrogen in the inflammatory milieu of endometriosis: A molecular and pathophysiological perspective

Humaira Shah, Shah H, Naguib Salleh, Salleh N, Hamdan M, Mukhri Hamdan, Giribabu N, Nelli Giribabu
Journal of Reproductive Immunology · 2026 · vol. 175 , pp. 104868 · doi:10.1016/j.jri.2026.104868 · PMID:41825100
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This review explores how gut microbiota dysbiosis may alter estrogen levels, inflammation, and oxidative stress in endometriosis, potentially aiding in biomarker discovery and personalized treatment.

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Abstract

Endometriosis is a prevalent estrogen-dependent chronic inflammatory condition that affects millions of women of reproductive age worldwide. It is characterized by the growth of endometrial tissue outside the uterine cavity, which leads to persistent inflammation, pain, and infertility. It is a multifaceted condition with a poorly understood etiology and pathogenesis resulting from several aberrant biological processes. Among these, elevated estrogen levels are considered the primary trophic factors. Intracrine estrogen biosynthesis by endometriotic lesions, anomalous expression of estrogen receptors and enzymes, and dysregulation of estrogen metabolism collectively contribute to the chronic inflammatory milieu of endometriosis. Inflammation further sustains these activities and perpetuates a vicious cycle. Gut microbiota homeostasis has emerged as a key modulator of estrogen metabolism and inflammation in several estrogen-sensitive diseases. A bidirectional interaction between gut microbiota and endometriosis has been reported. This review aimed to explore the potential role of gut dysbiosis in circulating estrogen levels, inflammation, and oxidative stress in endometriosis. Understanding the interactions between estrogen, inflammatory pathways, and the gut microbiota may help in the early detection of endometriosis through specific microbial and inflammatory biomarkers. Additionally, this may pave the way for the development of personalized treatment plans based on individual microbial profiles and hormonal status, and to enhance clinical practice by guiding anti-inflammatory microbes in probiotic therapies and identifying effective prebiotic treatments.

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Condition tags

endometriosisinfertility

MeSH descriptors

Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis Dysbiosis

Funding

funders
[{'doi': '10.13039/501100003093', 'name': 'Ministry of Higher Education, Malaysia', 'awards': ['FRGS/FP011-2023/UM']}]

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 (100)

SciLite annotations

organisms 6
microbiota noordeloos 2009062 microbiota microbiota microbiota bacteria stick insect
chemicals 8
estrogen estrogen estrogen estrogen estrogen estrogen estrogen estrogen

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