Did you know that your gut microbiome plays a key role in your overall health – and may even affect how endometriosis develops? Recent research suggests that the beneficial bacteria in your gut do much more than support digestion and immunity. They may also influence the course of endometriosis. Read on to discover how nurturing your gut health could potentially help alleviate your symptoms.
What Is the Microbiome, and Why Is It Important?
The term microbiome refers to the trillions of microorganisms that live in and on your body, with the gut being home to a large portion of them. These beneficial bacteria are essential for digestion, immunity, and reducing inflammation throughout the body. However, studies have found that women with endometriosis often have higher levels of harmful bacteria in the mouth, vagina, stool, and cervix, suggesting an imbalance in their microbiome.
The Microbiome and Oestrogen Metabolism
For women with endometriosis, the connection between gut bacteria and hormone balance is particularly relevant. Some gut bacteria play a role in regulating oestrogen levels, which are crucial in managing the condition.
Hormones and Endometriosis: A Quick Overview
- Oestrogen: This group of female sex hormones is vital for reproductive health. It supports the growth of the uterine lining during the menstrual cycle in preparation for pregnancy. However, in endometriosis, oestrogen also stimulates the growth of endometrial tissue outside the uterus, worsening symptoms.
- Progesterone: Known as the “corpus luteum hormone,” progesterone plays a protective role by regulating uterine lining growth, reducing inflammation, and preventing the spread of endometrial tissue. In women with endometriosis, progesterone’s effects are often diminished, leaving oestrogen unchecked.
The delicate balance between oestrogen and progesterone is crucial for uterine health. When this balance is disrupted, oestrogen can fuel the growth of endometriosis lesions, while the protective role of progesterone weakens. Understanding this relationship helps pave the way for treatments that restore hormonal equilibrium and alleviate symptoms.
How Gut Bacteria Impact Oestrogen Levels
Gut bacteria don’t produce oestrogen themselves, but they significantly influence how the body processes and eliminates excess hormones. Before oestrogen and other hormone-like substances (from food, cosmetics, or medications) can leave the body, they must first be bound to glucuronic acid to become water-soluble and inactive.
Some gut bacteria produce an enzyme called β-glucuronidase, which removes glucuronic acid from these hormones, reactivating them. This allows the hormones to be reabsorbed through the intestinal wall instead of being excreted.
- High β-glucuronidase activity: Leads to excess oestrogen being recycled in the body, potentially worsening hormone imbalances.
- Low β-glucuronidase activity: Reduces the amount of oestrogen available, which can also cause problems.
An imbalanced gut microbiome (dysbiosis) can therefore disrupt hormone metabolism, contributing to oestrogen dominance – a common issue in women with endometriosis.
How to Support Your Microbiome
A balanced diet is essential for maintaining a healthy gut microbiome and promoting hormonal balance. Here are some tips to nurture your beneficial gut bacteria:
- Eat a variety of fruits and vegetables: A colourful selection provides diverse nutrients to support healthy bacterial growth.
- Increase fibre intake: Whole grains, legumes, and flaxseeds feed beneficial bacteria and encourage their growth. Fibre-rich diets have also been shown to reduce oestrogen levels in the blood.
- Include fermented foods: Yogurt, sauerkraut, kimchi, and kefir contain probiotics that help maintain a healthy gut microbiome.
What Harms the Microbiome?
Just as it’s important to support your gut bacteria, it’s equally crucial to avoid factors that harm them. Stress, poor dietary choices, and frequent antibiotic use can negatively impact your microbiome, disrupting its delicate balance.
Find Your Balance
Your gut microbiome is a powerful ally in your health journey – and it may play a pivotal role in managing endometriosis. Have you made changes to your diet or lifestyle that have helped with your symptoms? Share your experiences in the comments!
Follow us for more tips and insights on endometriosis and overall health. Remember: a healthy diet is the first step toward feeling better – and your gut and endometriosis will thank you for it! 💚
References
Abulughod N, Valakas S, El-Assaad F. Dietary and Nutritional Interventions for the Management of Endometriosis. Nutrients. 2024 Nov 21;16(23):3988. doi: 10.3390/nu16233988. PMID: 39683382; PMCID: PMC11643425.
Ata, B.; Yildiz, S.; Turkgeldi, E.; Brocal, V.P.; Dinleyici, E.C.; Moya, A.; Urman, B. The Endobiota Study: Comparison of Vaginal, Cervical and Gut Microbiota Between Women with Stage 3/4 Endometriosis and Healthy Controls. Sci. Rep. 2019, 9, 2204.
Baker, J.M.; Al-Nakkash, L.; Herbst-Kralovetz, M.M. Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas 2017, 103, 45–53.
Chang, C.Y.; Chiang, A.J.; Lai, M.T.; Yan, M.J.; Tseng, C.C.; Lo, L.C.; Wan, L.; Li, C.J.; Tsui, K.H.; Chen, C.M.; et al. A More Diverse Cervical Microbiome Associates with Better Clinical Outcomes in Patients with Endometriosis: A Pilot Study. Biomedicines 2022, 10, 174.
Hou, H.T.; Lin, T.C.; Wu, M.H.; Tsai, S.J. Feel so bac: Is Fusobacterium the suspect causing endometriosis? Trends Mol. Med. 2023, 29, 780–782.
Ji, X.; Yang, Q.; Zhu, X.L.; Xu, L.; Guo, J.Y.; Rong, Y.; Cai, Y.L. Association between gut microbiota and endometriosis: A two-sample Mendelian randomization study. Front. Microbiol. 2023, 14, 1188458
Khan, K.N.; de Ziegler, D.; Guo, S.W. Bacterial infection in endometriosis: A silver-lining for the development of new nonhormonal therapy? Hum. Reprod. 2024, 39, 623–631.
Marquardt RM, Kim TH, Shin JH, Jeong JW. Progesterone and Estrogen Signaling in the Endometrium: What Goes Wrong in Endometriosis? Int J Mol Sci. 2019 Aug 5;20(15):3822. doi: 10.3390/ijms20153822. PMID: 31387263; PMCID: PMC6695957.
Muraoka, A.; Suzuki, M.; Hamaguchi, T.; Watanabe, S.; Iijima, K.; Murofushi, Y.; Shinjo, K.; Osuka, S.; Hariyama, Y.; Ito, M.; et al. Fusobacterium infection facilitates the development of endometriosis through the phenotypic transition of endometrial fibroblasts. Sci. Transl. Med. 2023, 15, eadd1531.
Pai, A.H.; Wang, Y.W.; Lu, P.C.; Wu, H.M.; Xu, J.L.; Huang, H.Y. Gut Microbiome-Estrobolome Profile in Reproductive-Age Women with Endometriosis. Int. J. Mol. Sci. 2023, 24, 16301.
Pérez-Prieto, I.; Vargas, E.; Salas-Espejo, E.; Lüll, K.; Canha-Gouveia, A.; Pérez, L.A.; Fontes, J.; Salumets, A.; Andreson, R.; Aasmets, O.; et al. Gut microbiome in endometriosis: A cohort study on 1000 individuals. BMC Med. 2024, 22, 294.
Svensson, A.; Brunkwall, L.; Roth, B.; Orho-Melander, M.; Ohlsson, B. Associations Between Endometriosis and Gut Microbiota. Reprod. Sci. 2021, 28, 2367–2377
Ustianowska K, Ustianowski Ł, Machaj F, Gorący A, Rosik J, Szostak B, Szostak J, Pawlik A. The Role of the Human Microbiome in the Pathogenesis of Pain. Int J Mol Sci. 2022 Oct 31;23(21):13267. doi: 10.3390/ijms232113267. PMID: 36362056; PMCID: PMC9659276.
