Endometriosis is a painful condition where tissue similar to the uterine lining grows in the wrong places, causing inflammation and severe symptoms. New research suggests that an imbalance in gut bacteria might be connected to this condition. Scientists are exploring whether fixing the balance of good and bad bacteria in your digestive system—through probiotics or other treatments—could help reduce endometriosis symptoms. This review examines how gut health and endometriosis are linked and discusses promising new ways to diagnose and treat the condition without invasive surgery.
The Quick Take
- What they studied: How the balance of bacteria in your gut might contribute to endometriosis and whether changing your gut bacteria could help treat the condition
- Who participated: This is a review article that examined many existing studies about endometriosis and gut bacteria, rather than a single study with participants
- Key finding: People with endometriosis appear to have different types and amounts of bacteria in their gut compared to people without the condition, particularly lower levels of helpful Lactobacillus bacteria and higher levels of harmful E. coli
- What it means for you: If you have endometriosis, paying attention to your gut health through diet, probiotics, or other microbiome-focused treatments may eventually help reduce your symptoms, though more research is needed before doctors can recommend specific treatments
The Research Details
This is a review article, which means researchers looked at many existing studies about endometriosis and gut bacteria to understand what scientists have already discovered. Rather than conducting their own experiment with patients, the authors gathered information from published research to identify patterns and connections. They examined how an imbalance in gut bacteria (called dysbiosis) might trigger inflammation and immune system problems that make endometriosis worse. The review also looked at new treatment ideas, including using probiotics (good bacteria supplements) and fecal microbiota transplantation (transferring healthy bacteria from one person to another), as well as measuring special bacterial byproducts called short-chain fatty acids that might help diagnose the condition without surgery.
Understanding how gut bacteria connect to endometriosis is important because current treatments often require invasive surgery to diagnose the condition and don’t work well for everyone. If scientists can identify specific bacterial imbalances that cause endometriosis, they might develop simple blood tests or stool tests to diagnose it without surgery. Additionally, treating the gut microbiome could offer a new way to help patients feel better without major medical procedures.
This is a review article that summarizes existing research rather than presenting new experimental data. Review articles are helpful for understanding what scientists currently know, but they don’t provide the strongest level of evidence on their own. The findings are based on emerging research, meaning some ideas are still being tested and may change as more studies are completed. Readers should understand that while the connections between gut bacteria and endometriosis are promising, many of the proposed treatments still need more testing in clinical trials before doctors can confidently recommend them to patients.
What the Results Show
Research shows that people with endometriosis have different gut bacteria compared to people without the condition. Specifically, they tend to have lower levels of Lactobacillus, which is a type of helpful bacteria, and higher levels of harmful bacteria like E. coli. This imbalance appears to trigger chronic inflammation in the body and cause problems with the immune system, which may make endometriosis symptoms worse. The review suggests that this bacterial imbalance might be one of the reasons why endometriosis develops and why it causes so much pain and discomfort. Scientists believe that if they can restore the balance of good bacteria in the gut, they might be able to reduce inflammation and help people with endometriosis feel better.
The review also discusses how bacterial byproducts called short-chain fatty acids (SCFAs) appear to be important for controlling inflammation and immune responses. These special molecules are created when good bacteria break down fiber in your diet. People with endometriosis may have lower levels of these helpful byproducts, which could contribute to their symptoms. Additionally, the research suggests that endometriosis affects not just physical health but also mental health and quality of life, making it important to find effective treatments.
This research builds on earlier discoveries showing that many chronic inflammatory conditions are connected to gut bacteria imbalances. The connection between gut health and endometriosis is relatively new compared to other conditions, but it fits with what scientists already know about how bacteria influence inflammation throughout the body. Previous research on other conditions has shown that probiotics and dietary changes can help restore healthy bacteria, suggesting similar approaches might work for endometriosis.
This review has several important limitations. First, it summarizes existing studies rather than providing new experimental evidence, so the strength of the findings depends on the quality of those earlier studies. Second, while scientists have identified bacterial differences in people with endometriosis, they haven’t yet proven that these differences actually cause the condition or that fixing them will definitely help patients. Third, most of the proposed treatments like probiotics and fecal microbiota transplantation are still being tested and haven’t been proven safe and effective for endometriosis in large clinical trials. Finally, the review notes that researchers still don’t fully understand exactly how gut bacteria influence endometriosis, and more studies are needed to answer important questions.
The Bottom Line
Based on current evidence, people with endometriosis may benefit from paying attention to gut health through a fiber-rich diet that feeds good bacteria, though this is a supportive approach rather than a proven treatment. Probiotic supplements containing Lactobacillus may be worth discussing with your doctor, but they should not replace standard medical care. More research is needed before doctors can confidently recommend specific microbiome treatments for endometriosis. Confidence level: Low to Moderate—these are promising directions but not yet proven treatments.
Anyone with endometriosis or suspected endometriosis should be aware of this research, as it offers hope for new treatment options. People interested in natural or less invasive approaches to managing endometriosis may find this particularly relevant. However, this research is not yet ready to replace current medical treatments, and people with endometriosis should continue working with their healthcare providers. This information is less relevant for people without endometriosis, though maintaining good gut health is beneficial for everyone.
If microbiome-based treatments become available, it would likely take several weeks to months to notice improvements in symptoms, similar to how other treatments for endometriosis work. However, since these treatments are still being researched, it may be 2-5 years before doctors can recommend specific microbiome therapies based on strong scientific evidence.
Want to Apply This Research?
- Track daily symptoms (pain level on a scale of 1-10, bloating, fatigue) alongside dietary fiber intake and any probiotic supplements taken. This helps identify patterns between gut health habits and endometriosis symptom severity over time.
- Start increasing fiber intake gradually through foods like vegetables, fruits, whole grains, and legumes, which feed beneficial gut bacteria. Users can set daily fiber goals and log meals to monitor progress while tracking how symptoms change.
- Create a weekly summary dashboard showing symptom trends, fiber intake patterns, and probiotic use. Users can share this data with their healthcare provider to discuss whether dietary and microbiome-focused changes are helping their endometriosis symptoms.
This article summarizes emerging research about the connection between gut bacteria and endometriosis. The findings are promising but not yet proven as standard medical treatments. If you have endometriosis or suspect you might, please consult with a healthcare provider before starting any new treatments, including probiotics or major dietary changes. This information should not replace professional medical advice, diagnosis, or treatment. Always discuss new health approaches with your doctor, especially if you are taking medications or have other health conditions.