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Endometriosis and the Microbiome

Updated: Feb 14

What is Endometriosis?

Endometriosis is a condition in which estrogen-dependent endometrial tissue grows outside of the uterus.

Its prime targets are women of reproductive age: symptoms including pelvic pain and infertility, painful menstruation, dyspareunia (painful sexual intercourse) and pain on urination.

Teenage girls can have endometriosis. Women can continue to suffer from it even after menopause, or after a hysterectomy.

It is difficult to diagnose accurately and although there are a range of treatments, none of them are entirely effective and there is no known cure.

What about the Microbiome?

For many years, it was thought that our internal organs were a sterile environment. Then we developed ways of detecting the tiny microbes, and we figured out we're full of critters!

Microbes aren't just in our digestive tract. Our reproductive tract has multiple zones with their own colonies of microbes. (Ref.) The uterus, fallopian tubes and vagina each have their own microbiome, and so does endometrial tissue.

The proportions of various bacteria on the endometrium are different to the vagina, but many of the same types are present in both areas. In both, the ideal dominant species are Lactobacilli.

Recent research has found connections between microbiota and endometriosis, which may lead to new treatment options in the future.

Key microbes have been identified in women with endometriosis, implying that either endometriosis or the resulting inflammation is linked to microbial imbalance.

The idea that a persistent microbiome imbalance could lead to chronic inflammation in the reproductive tract is relatively new, but research has begun. Research into the gut microbiome has shown strong links between microbiome imbalance and immune function issues.

To get technical, studies have found endometriosis associated with increased levels of Proteobacteria, Enterobacteriaceae, Streptococcus and Escherichia coli across various microbiome sites. These are bacteria typically considered to be unfriendly or pathogenic.

Just like in the vagina, this comes with a corresponding reduction in the proportion of Lactobacilli species. Check out Vaginal Microbiome Basics for why Lactobacilli are the heroes of the vaginal microbiome.

This change in the endometrial microbiome was found to reduce a woman’s immune function and make her more susceptible to pathogens.

That isn’t surprising, since it’s exactly what's been found to happen in the vagina.

Research findings imply (without fully proving) that the pathology of endometriosis could be related to microbes traveling up the reproductive tract and creating an imbalance in the endometrial microbiome.

What Does It Mean For Us?

Further research into endometrial bacteria could present new and more effective treatment options for endometriosis in the future. (Reference) The boffins are onto it, but we'll have to wait for them to find a targeted way of boosting the good microbes or hampering the rascals in order to reduce the pain and suffering caused by endometriosis

For the moment, we can't go far wrong by

  • eating well, supplying our gut with prebiotic fibre-rich foods to support the gut microbiome which seems to be something of a control-board for the rest of our body

  • practicing good vaginal hygiene to support the microbiome at that end of the reproductive system

  • visiting the QENDO website for valuable information and support for anyone affected by endometriosis, adenomyosis, PCOS, infertility or pelvic pain. Check them out at

Find the rest of the series on Vaginal Health HERE!

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