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Is Our Gut Bacteria Involved in Endometriosis?

As a nutritionist who specializes in endometriosis and gut health, when I learned there could be a connection between the microbes in our gut and endometriosis, I was instantly fascinated. Our gut and microbiome are implicated in diseases ranging from obesity, type 2 diabetes, inflammatory bowel disease, to cancer.1 Given many women with endometriosis also suffer from gut health problems such as irritable bowel syndrome (IBS) and small intestine bacterial overgrowth (SIBO), it doesn’t seem too far fetched that our gut might play a role in the disease.

About the microbiome

The human gut microbiome encompasses a range of organisms such as bacteria, viruses, and fungi that live within the intestinal tract. Microbes in the gut contribute to human health through production of vitamins, amino acids (the building blocks of protein), as well as the generation of important metabolic by-products such as short chain fatty acids, which act as an energy source for intestinal cells which strengthen the intestinal barrier.

Aside from being the place where we absorb all of our nutrients so we can stay alive, here are some reasons why the microbiome and our gut are important:

  • The gut microbiome maintains the integrity of the intestinal lining preventing bacteria from moving out of the gut, which can cause systemic inflammation.2
  • The gut houses majority of our immune system and the microbiome influences the immune system.2
  • Around 80% of serotonin (which is important for mood regulation) is produced in the gut.
  • The microbiome can signal to the brain and alter the production of neurotransmitters such as serotonin affecting mood.3
  • Our gut health can also impact the liver, which is important for a range of functions including detoxification of hormones and medication.
  • Poor gut health can lead to food sensitivities, further contributing to inflammation and malabsorption of food.
  • Unhealthy diet and excess stress can negatively impact the microbiome leading to circadian rhythm (sleep/wake cycle) disruption.1
  • As noted above, gut health and the microbiome is implicated in many serious diseases such as cancer and type 2 diabetes.1

The microbiome and endometriosis

Endometriosis is a disease that involves a dysfunctional immune response and inflammation; There is even evidence that suggests the microbiome may influence the immune response in endometriosis.2

Endometriosis appears to be associated with increased levels of certain types of bacteria such as Escherichia coli (E. Coli), a type of bacteria known to produce a toxin called lipopolysaccharide (LPS), which causes an inflammatory response.2 One theory is that these pro-inflammatory bacteria and LPS may have moved from the gut into the pelvic cavity promoting the onset and progression of endometriosis lesions.2

Remember that bacteria aren’t supposed to move from the gut to other locations in the body, this only tends to happen when the integrity of the intestinal lining is compromised – which is also known as ‘leaky gut’.

In addition, the gut microbiome can also alter estrogen metabolism. When our microbiome is imbalanced (known as dysbiosis), it can actually increase the amount of free circulating estrogen; given endometriosis is an estrogen dependent condition, this is not an ideal situation (3).

What you can do

Here are some ways to support your gut health and microbiome:

  • Consume plenty of fiber from whole foods, such as vegetables, fruit, whole grains, nuts, seeds, and legumes. Eat at least 5 serves of vegetables per day.
  • Try supplementing with soluble fiber such as psyllium husk, slippery elm, partially hydrolysed guar gum (PHGG), or freshly ground flaxseed.
  • Support your microbiome with fermented foods such as sauerkraut or kefir.
  • Drink plenty of water, around 2.5 litres is optimal to support healthy digestion and elimination.
  • Address food intolerances as these contribute to inflammation and abdominal pain. If you are struggling with digestive health, see a nutritionist.
  • Limit your red meat intake to once a week.
  • Avoid alcohol, sugar, trans fats, and processed foods.
  • Manage your stress levels; try belly breathing, yoga or spending time in nature.

Yours in health,
Meredith

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Endometriosis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Singh, R. K., Chang, H. W., Yan, D., Lee, K. M., Ucmak, D., Wong, K., … Liao, W. (2017). Influence of diet on the gut microbiome and implications for human health. Journal of translational medicine, 15(1), 73. doi:10.1186/s12967-017-1175-y
  2. Leonardi, M., Hicks, C., El‐Assaad, F., El‐Omar, E., & Condous, G. (2019). Endometriosis and the microbiome: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology. doi:10.1111/1471-0528.15916
  3. Arneth, B. M. (2018). Gut–brain axis biochemical signalling from the gastrointestinal tract to the central nervous system: gut dysbiosis and altered brain function. Postgraduate Medical Journal, postgradmedj–2017–135424. doi:10.1136/postgradmedj-2017-135424

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