Current Updates on the Role of Microbiome in Endometriosis: A Narrative Review Original paper
Researched by:
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Karen Pendergrass
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Karen Pendergrass
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.
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Karen Pendergrass
Researched by:
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Karen Pendergrass
ID
Karen Pendergrass
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Karen Pendergrass
What Was Reviewed?
This narrative review explores the role of the microbiome in the pathogenesis and progression of endometriosis. It synthesizes data from clinical and preclinical studies on the microbial signatures in various body sites, including the gut, vaginal, cervical, and peritoneal microbiomes. The review emphasizes the emerging evidence of urogenital-gastrointestinal microbiome crosstalk and its implications for the development of microbiome-targeted interventions (MBTIs) for endometriosis.
Who Was Reviewed?
The review primarily focuses on studies involving women diagnosed with endometriosis across different geographical locations, such as Asia, Europe, and North and South America. It also includes research on animal models of endometriosis to evaluate microbial dynamics and their potential role in disease progression.
Most Important Findings
The review highlights substantial alterations in microbiome composition across the reproductive tract, gut, and peritoneal cavity in individuals with endometriosis. These changes underscore the interplay between microbial dysbiosis and disease progression, suggesting both diagnostic and therapeutic potential. These findings illuminate the microbiome’s dual role in reflecting and influencing endometriosis progression. By leveraging microbial markers for disease staging and understanding the contribution of dysbiosis, researchers can develop targeted diagnostics and microbiome-modulating interventions to improve patient outcomes. The table below summarizes the key findings from the review.
| Microbiome Site | Changes Observed | Significance |
|---|---|---|
| Reproductive Tract | Reduced Lactobacillus species (e.g., Lactobacillus crispatus) and increased Streptococcus, Enterobacteriaceae, and Pseudomonas. | Dysbiosis may compromise the protective low pH environment, facilitating pathogen colonization and inflammation in the vaginal and cervical microbiomes. |
| Gut Microbiome | Higher Firmicutes/Bacteroidetes ratio, increased Actinobacteria and Proteobacteria, enriched Prevotella and Eggerthella, depleted Lachnospiraceae and Ruminococcaceae. | Gut dysbiosis may contribute to systemic inflammation and immune dysregulation, promoting endometriosis progression. |
| Peritoneal Microbiome | Elevated Acidovorax, Streptococcus, and Pseudomonadaceae; reduced Actinomycetales. | Unique microbial profiles in the peritoneal cavity may directly influence lesion development and immune response in endometriosis. |
| Disease Staging | Early stages (I–II): Lactobacillus jensenii, Corynebacteriales. Advanced stages (III–IV): Bifidobacterium breve, Streptococcaceae. | Distinct microbial signatures associated with disease stages provide potential biomarkers for diagnostics and insights into disease progression. |
Greatest Implications
The review underscores the potential for microbiome-targeted therapies and diagnostics in managing endometriosis. The identification of microbial biomarkers could enhance non-invasive diagnostic accuracy and enable personalized treatment approaches. Additionally, interventions aimed at restoring microbial balance—such as probiotics, prebiotics, and microbiome-modulating drugs—offer promising avenues for alleviating symptoms and potentially altering disease progression.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
Microbiome-Targeted Interventions (MBTIs)
Microbiome Targeted Interventions (MBTIs) are cutting-edge treatments that utilize information from Microbiome Signatures to modulate the microbiome, revolutionizing medicine with unparalleled precision and impact.