The role of gut and genital microbiota and the estrobolome in endometriosis, infertility and chronic pelvic pain 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
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Karen Pendergrass
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Women’s Health
Women’s Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
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Endometriosis
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.
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Chronic Pelvic Pain (CPP)
Chronic Pelvic Pain (CPP)
Chronic Pelvic Pain (CPP) is persistent pain in the pelvic region lasting six months or longer, often multifactorial, impacting physical and emotional well-being, and associated with various medical conditions.
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Infertility
Infertility
Infertility is the inability to conceive after 12 months of regular, unprotected sex. It affects both men and women and can be due to various physical, hormonal, or genetic factors. Treatments include medication, surgery, assisted reproductive technologies, and lifestyle changes.
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Karen Pendergrass
Researched by:
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Karen Pendergrass
ID
Karen Pendergrass
Fact-checked 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?
The reviewed manuscript explored the intricate relationship between the gut and genital microbiomes, the estrobolome, and their roles in the pathophysiology of endometriosis, infertility, and chronic pelvic pain (CPP). The authors critically examined 28 clinical and six preclinical studies to understand microbial dysbiosis’s contributions to estrogen metabolism, inflammation, and symptomatology in these conditions. This review also identified methodological gaps in microbiome studies and proposed strategies to improve future research.
Who was reviewed?
The review included human and animal studies, examining women diagnosed with endometriosis, infertility, and CPP, alongside healthy controls. Specific focus was placed on microbial associations in the gut, cervicovaginal, and endometrial microbiomes, with emphasis on bacterial vaginosis-associated bacteria, Lactobacillus depletion, and microbial influences on estrogen-driven mechanisms.
What were the most important findings?
Key findings highlighted that dysbiosis in the gut microbiome disrupts the estrobolome, an essential modulator of estrogen metabolism. This disruption contributes to heightened systemic and local inflammation, potentially exacerbating endometriosis symptoms and infertility. Many studies noted an association between bacterial vaginosis-related bacteria and a reduction in Lactobacillus dominance in the cervicovaginal microbiome with the prevalence of endometriosis and infertility. Additionally, the review underscored a bidirectional relationship between gut microbiota and endometriosis progression in animal models, emphasizing the role of gut dysbiosis in increasing b-glucuronidase activity, leading to elevated circulating estrogen levels.
What are the greatest implications of this review?
This review underscores the need for rigorous, standardized methodologies to better delineate causal relationships between microbiota and gynecological conditions like endometriosis and CPP. The findings of this review suggest that targeting the microbiome could lead to novel diagnostics and therapeutics for estrogen-driven diseases. The review also highlights the potential of leveraging microbiome-based biomarkers for non-invasive diagnostics and monitoring of endometriosis progression, bridging a critical translational gap in gynecological health.
Estrobolome
The estrobolome is a group of gut bacteria that metabolize estrogen, impacting its levels and effects in the body. By modulating estrogen reabsorption and excretion, the estrobolome influences hormonal balance and risks of estrogen-related conditions, making it a target for therapeutic interventions.
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.
Infertility
Infertility is the inability to conceive after 12 months of regular, unprotected sex. It affects both men and women and can be due to various physical, hormonal, or genetic factors. Treatments include medication, surgery, assisted reproductive technologies, and lifestyle changes.
Chronic Pelvic Pain (CPP)
Chronic Pelvic Pain (CPP) is persistent pain in the pelvic region lasting six months or longer, often multifactorial, impacting physical and emotional well-being, and associated with various medical conditions.
β-Glucuronidase
β-glucuronidase in the gut microbiome breaks down metabolites, drugs, and hormone conjugates like estrogen, aiding microbial energy use and nutrient cycling. Its activity influences drug efficacy and hormone levels, maintaining estrogen balance and impacting health. Disruption in this process can lead to estrogen-related diseases, such as gynecological cancers and menopausal syndrome, and increase colorectal cancer risks by reactivating carcinogens, highlighting its pivotal role in linking microbial actions to host physiological processes.