Intricate Connections between the Microbiota and Endometriosis

Irene Jiang, Paul J Yong, Catherine Allaire, Mohamed A Bedaiwy
International journal of molecular sciences · 2021 · vol. 22(11) , pp. 5644 · doi:10.3390/ijms22115644 · PMID:34073257 · W3165391538
review OA: gold CC0 ⤵ 100 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper reviews how gut and reproductive tract dysbiosis can promote endometriosis pathogenesis through immune dysregulation, inflammation, and altered cellular processes, with potential therapeutic implications for antibiotics and probiotics.

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Abstract

Imbalances in gut and reproductive tract microbiota composition, known as dysbiosis, disrupt normal immune function, leading to the elevation of proinflammatory cytokines, compromised immunosurveillance and altered immune cell profiles, all of which may contribute to the pathogenesis of endometriosis. Over time, this immune dysregulation can progress into a chronic state of inflammation, creating an environment conducive to increased adhesion and angiogenesis, which may drive the vicious cycle of endometriosis onset and progression. Recent studies have demonstrated both the ability of endometriosis to induce microbiota changes, and the ability of antibiotics to treat endometriosis. Endometriotic microbiotas have been consistently associated with diminished Lactobacillus dominance, as well as the elevated abundance of bacterial vaginosis-related bacteria and other opportunistic pathogens. Possible explanations for the implications of dysbiosis in endometriosis include the Bacterial Contamination Theory and immune activation, cytokine-impaired gut function, altered estrogen metabolism and signaling, and aberrant progenitor and stem-cell homeostasis. Although preliminary, antibiotic and probiotic treatments have demonstrated efficacy in treating endometriosis, and female reproductive tract (FRT) microbiota sampling has successfully predicted disease risk and stage. Future research should aim to characterize the “core” upper FRT microbiota and elucidate mechanisms behind the relationship between the microbiota and endometriosis.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Dysbiosis Endometriosis Lactobacillus Lactobacillus Lactobacillus Microbiota Dysbiosis Dysbiosis Endometriosis Endometriosis Female Humans

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)

Cited by (50)

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