Gut Microbiome Linked to Endometriosis

A new study suggests that an altered gut microbiome plays a significant role in endometriosis progression in mice.

At least 11% of women in the U.S. have endometriosis, a condition where the kind of tissue that normally lines the uterus grows somewhere else, such as on the ovaries, the bowels, or the bladder. Despite the disease being widespread, there is little known about its causes.

The study from researchers at Baylor College of Medicine published in the journal Cell Death & Discovery provides novel insights into how an altered microbiome, a community of microorganisms living inside the body, affects the development of endometriosis.

The researchers discovered that mice lacking gut microbiome had smaller endometriotic lesions than mice with a microbiome. In addition, when gut microbiota from mice with endometriosis was transplanted into gut microbiome-free mice, the lesions grew as large as those in mice retaining their microbiome.

These findings suggest that altered gut bacteria drive endometriosis progression. The uterine microbiome, on the other hand, did not affect disease progression.

Researchers are now investigating the possibility that modifying the composition of certain microbiome communities that contribute to endometriosis progression could help to control the condition in humans.

Endometriosis may be linked to bowel issues

Any woman who has menstrual periods may develop endometriosis, but the condition is most common in women in their 30s and 40s.

Some women are more likely to get endometriosis than others. Those more at risk have:

• Family history of endometriosis
• Never had children
• Defects in the uterus or fallopian tubes
• Long menstrual periods (more than seven days)
• Short menstrual cycles (27 days or fewer)
• Heavy bleeding during menses

The study authors note that women with endometriosis often have bowel issues, such as colitis.

"We are interested in determining whether changes in the gut microbiome could affect bowel conditions and the possibility of controlling them by modifying the microbiome or with their metabolites," said Dr. Rama Kommagani, associate professor in the Departments of Pathology and Immunology and Molecular Virology and Microbiology at Baylor.

No cure, but treatments are available

While endometriosis growths are not cancerous, the condition may cause infertility and reduce the quality of life by causing severe pain, fatigue, anxiety, and depression. Currently, there is no cure for endometriosis, but early diagnosis and management may slow or stop the progression of the disease. Available treatment options include hormone therapy, pain medication, and surgical treatments.

Hormone therapy is used to treat endometriosis-associated pain and works by stopping the ovaries from producing hormones, including estrogen, and preventing ovulation. The treatment slows the growth and local activity of the uterus lining and endometrial lesions.

Mild pain can be relieved with pain medications, most commonly nonsteroidal anti-inflammatory drugs (NSAIDs). However, there is limited evidence on the effectiveness of treating endometriosis-associated pain.

During surgical treatment, areas of endometriosis are located, examined, and the endometriosis patches may be removed. The surgeries, however, offer only short-term relief from pain and may affect a woman's fertility.