Could the key to managing endometriosis lie in our gut? Join us in uncovering the latest research findings exploring how the gut microbiome is intricately linked to endometriosis, and equip yourself with essential insights that could impact your well-being.
Key Takeaways: The Gut-Endometriosis Connection
1️ Your Gut Microbiome Influences Endometriosis
Research shows that females with endometriosis often have imbalanced gut bacteria (dysbiosis), leading to increased inflammation, immune dysfunction, and hormone imbalances, all of which can worsen symptoms.
2️ Inflammation is a Key Driver
A disrupted gut microbiome can contribute to chronic systemic inflammation, a hallmark of endometriosis. Certain gut bacteria influence inflammatory pathways, making gut health a crucial factor in symptom management.
3️ Your Gut Helps Regulate Oestrogen
The gut microbiome plays a role in oestrogen metabolism, meaning an imbalance in gut bacteria can contribute to excess oestrogen, potentially fuelling the growth of endometrial lesions.
4 Optimising Your Gut Microbiome is a Therapeutic Strategy
Supporting your gut with fibre-rich foods & prebiotics helps increase short chain fatty acid production which may reduce endometrial lesion growth, reduce inflammation, regulate hormones, and improve digestion.
Want to learn how to nurture your gut for better endometriosis management? Keep reading.
Understanding Endometriosis & Endometriosis Symptoms
Endometriosis is a chronic and often painful condition that occurs when tissue similar to the lining of the uterus, known as the endometrium, begins to grow outside the uterus. This abnormal growth can lead to a range of symptoms including:
- Pelvic pain
- Fatigue
- Pain with intercourse
- Heavy menstrual bleeding
- Infertility
- Gastrointestinal symptoms
- Short luteal phase
Endometriosis affects approximately 1 in 10 women of reproductive age, yet diagnosing the condition remains a challenge, often taking 6 to 8 years from the onset of symptoms. While the exact cause is unknown, research suggests a complex interplay of genetic, hormonal, and environmental factors. Symptoms range from mild discomfort to severe, debilitating pain, with tissue growth commonly occurring on the ovaries, fallopian tubes, and pelvic lining, sometimes extending beyond.
Despite its prevalence, early-stage endometriosis is difficult to detect with standard imaging, often requiring laparoscopic surgery for confirmation. Many cases are misdiagnosed as conditions like IBS, further delaying proper treatment.
Raising awareness and understanding endometriosis is crucial, whether you have it or not. Education can help reduce diagnostic delays and support better management strategies, including the emerging role of gut health in symptom regulation.
The Gut-Endometriosis Connection
The gut microbiome, which consists of trillions of microorganisms living in our digestive tract, plays a critical role in overall health, including immune function, inflammation regulation, and hormone metabolism. Disruptions in the gut microbiome, known as dysbiosis, have been linked to various chronic conditions, including autoimmune diseases, metabolic disorders, and even endometriosis.
With endometriosis there are shifts in the gut microbiome. The majority of research shows a depletion of protective microorganisms in the faeces of individuals with endometriosis and an increase of the abundance of pathogenic bacteria in the abdominal cavity (the peritoneal fluid).
In one study over 19 species could distinguish between individuals with endometriosis and those without, while another identified microbiome shifts across different disease stages.
How does our gut health impact endometriosis? Let’s explore the connections.
Short Chain Fatty Acid Production
Beneficial microbes living in our gut make beneficial short chain fatty acids. One of these short chain fatty acids is butyrate.
Butyrate is anti-inflammatory, improves metabolism (improve insulin sensitivity and reduce obesity), boosts immune function and keeps our intestinal barrier strong. Preclinical models of endometriosis even show that butyrate can reduce endometrial lesion growth and inflammation.
Reductions in butyrate producing microbes have been reported in individuals with endometriosis.
Dietary fibre intake is one of the best predictors of butyrate concentrations. Fibre is found in foods like wholegrains, fruits and vegetables. Diversity in your intake of plant based foods will promote a happy community of beneficial short chain fatty acid producing microbes.
The complex biochemical fibre structure of our key prebiotic in Microbiome Essentials also significantly increases butyrate production, supporting the growth of beneficial butyrate increasing bacteria including Bifidobacteria and Akkermansia.
Immune System & Inflammation
Our gut microbiome plays an important role in the process of inducing and training the maturity of the body’s immune system.
In experimental models a faecal microbial transplant from a mouse with endometriosis to a control damages the intestinal barrier, alters immune cell composition and function, and can increase systemic mediators of inflammation that drive lesion growth.
We can speculate that the onset and development of endometriosis may be related to the abnormal immune response caused by gut dysbiosis.
Disruptions in the gut microbiome are present in Endometriosis but also in autoimmune conditions. Research supports a significant association between endometriosis and increased risk of autoimmune diseases including Systemic Lupus Erythematosus, Rheumatoid Arthritis, Coeliac Disease, Irritable Bowel Disease and Multiple Sclerosis.
With 70-80% of immune cells being present in the gut, there is an intricate interplay between our gut microbiome and both local immunity and systemic immune function.
Human studies have identified specific bacterial populations that are associated with the risk of developing endometriosis, supporting the close connection between our gut microbiome, endometriosis progression and our immune system.
Gastrointestinal Symptoms & IBS
Up to 90% of individuals with endometriosis experience gastrointestinal symptoms including constipation, bloating, and nausea and vomiting. Females with endometriosis have an approximately 3-5 times greater risk of developing Irritable Bowel Syndrome (IBS) with rates of IBS as high as 52%.
IBS is characterised by chronic gut inflammation, bloating, and visceral pain – symptoms common in patients with a diagnosis of endometriosis.
Possible explanations for this increased risk of IBS include chronic low grade inflammation resulting from elevated mast cell activation, neuronal inflammation, increased intestinal permeability (leaky gut), and dysbiosis.
Disruptions in the gut microbiome can compromise the intestinal barrier, facilitate bacterial and endotoxin translocation, trigger inflammation and disrupt the immune environment. These shared characteristics across IBS and Endometriosis pave the way for therapeutic interventions targeting the gut microbiome.
Our key probiotic in Cacao Latte is clinically proven to reduce the severity of IBS symptoms including urgency, bloating, discomfort, gas production and abdominal pain.
Promoting the growth of beneficial species in the gut microbiome can support a reduction in gastrointestinal symptoms.
Hormone Regulation
Oestrogen plays a central role in endometriosis progression, as elevated oestrogen levels can drive the growth and survival of endometrial lesions outside the uterus. Beyond lesion growth, oestrogen also influences pain pathways by affecting nerve function and upregulating pro-inflammatory factors. However, oestrogen metabolism is not solely controlled by the ovaries—the gut microbiome plays a crucial role in oestrogen regulation, and in turn, oestrogen can shape the composition of the gut microbiome.
A specific subset of gut bacteria, known as the oestrobolome, is responsible for modulating circulating oestrogen levels. One of the primary ways the body eliminates oestrogen is through faecal excretion, but this process is significantly influenced by microbial activity.
Certain gut bacteria produce β-glucuronidase enzymes, which deconjugate estrogen in the intestines, allowing it to be reabsorbed into circulation rather than excreted. Increased β-glucuronidase activity has been linked to oestrogen dominance, macrophage dysfunction, and the promotion of endometriotic lesion development.
Targeting the gut microbiome may offer a supportive strategy for modulating oestrogen metabolism in endometriosis. Research suggests that dietary interventions, such as prebiotic glucomannan from konjac-based foods (e.g., low-calorie noodles and pasta), can reduce fecal β-glucuronidase activity, potentially lowering the reabsorption of oestrogen and helping to restore hormonal balance.
By nurturing a diverse and balanced gut microbiome, it may be possible to support healthy oestrogen metabolism and improve endometriosis symptom management.
Diet and Nutrition for Managing Endometriosis
Diet and nutrition play a pivotal role in managing endometriosis and supporting gut health. A microbiome enhancing diet can help reduce inflammation, balance hormones, and promote a healthy gut microbiome.
In a preclinical model where endometriosis was induced, a Western style diet induced lesions that were significantly twice as large compared to those on the control diet. Endometrial lesions on the Western Diet displayed greater levels of fibrosis and macrophage activation, and this was associated with greater microbiome disruption.
A Western diet high in saturated fats and low in fibre is known to compromise gut barrier function. This eating pattern leads to increased intestinal permeability and the leakage of toxic bacterial metabolites into circulation, potentially contributing to the development of low-grade systemic inflammation.
Certain dietary approaches have emerged as particularly beneficial for individuals with endometriosis. For instance, the Mediterranean diet, rich in fruits, vegetables, whole grains, healthy fats, and lean proteins, has been associated with reduced inflammation and improved overall health.
Foods such as fatty fish, walnuts, flaxseeds, and leafy greens are known for their anti-inflammatory properties and can help combat the chronic inflammation often seen in endometriosis. Additionally, avoiding processed foods, refined sugars, and trans fats can minimise inflammation and improve gut health.
The Power of Prebiotics
A well-nourished gut microbiome is essential for overall health, particularly in conditions like endometriosis, where inflammation plays a key role. One of the most beneficial compounds produced by gut bacteria is butyrate, a short-chain fatty acid that supports gut barrier integrity, modulates immune function, and reduces systemic inflammation.
Research has shown that higher dietary fibre intake is strongly associated with increased butyrate production, with a large study of over 2,800 females followed for seven years indicating that greater fibre consumption was linked to a reduced risk of developing endometriosis. Prebiotic fibres, found in wholegrains, fruits, and vegetables, provide the essential fuel for beneficial gut bacteria, promoting the growth of key butyrate-producing microbes.
Microbiome Essentials is specifically formulated to enhance butyrate production and support a balanced gut microbiome. Its complex prebiotic fibre structure promotes microbial diversity and stimulates the growth of beneficial bacteria, including Bifidobacteria and Akkermansia, which are known to increase butyrate levels.
Integrating targeted prebiotics like Microbiome Essentials helps naturally modulate the gut microbiome, creating a foundation for improved inflammatory balance and better therapeutic outcomes in endometriosis management.
Conclusion and Key Takeaways
The exploration of the link between endometriosis and gut health reveals a complex interplay that can significantly impact the well-being of individuals affected by this condition (my hand is up!).
Supporting a healthy gut microbiome reduces inflammation, supports hormone metabolism, restores intestinal integrity, enhances nutrient absorption and supports a healthy gut-brain axis supporting mood and pain management.
If you think you have endometriosis see your health care practitioner who can refer you to a specialist gynaecologist.
Are you nurturing your microbiome to manage endometriosis?
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