Endometriosis induces changes in our gut microbiota. With endometriosis there are distinct bacterial species present in our gut, and in the fluid in our abdominal cavity (peritoneal fluid).
If we were to look into our gut microbiome we have less beneficial microbes, and more of the species that can cause disruption. In the future we may even be able to use our microbiome to support how endometriosis is diagnosed.
Our gut microbiome and endometriosis are so intricately entwined that research models support that a distinct microbiome can even promote endometriosis.
Now let’s find out how nurturing our gut microbiome helps manage endometriosis.
Inflammation, and the resolution of inflammation, is usually a tightly regulated process. Controlled inflammation is essential for the process of ovulation and embryo implantation.
While short term inflammation is a normal, healthy response to acute stress, illness or injury, chronic low-grade inflammation can tick along in the background contributing to tissue damage and promoting disruption in hormone production and metabolism.
In individuals with endometriosis, levels of inflammation are higher in the abdominal cavity, ovaries and uterus . This elevated inflammation impacts our egg quality and uterine receptivity, and is one of the reasons it may be more difficult to get pregnant with endometriosis .
Inflammation from an overactive immune system drives the disease process of endometriosis. We may have an increase in mast cell activation and our debris clearing macrophages are not as effective at controlling cell proliferation, which can lead to endometrial lesion growth .
Our gut bacteria and the metabolites they produce shape our immune system. They can light a fire to drive more inflammation, or if we look after them they can help put out the fire. Nurturing the diversity of your gut microbiome is an effective strategy that helps reduce inflammation.
With more beneficial bacterial species in your gut more fertility loving compounds, like butyrate, are produced that dampen inflammation. Butyrate has also been shown to reduce lesion growth!
A healthy gut microbiome helps tame our immune system to reduce inflammation and dampen the disease process of endometriosis.
Strengthen Your Gut Barrier
Increased inflammation leads to disruption of intestinal cells that form a protective barrier between our food and our insides. Ever heard of ‘Leaky Gut’?
While ‘Leaky Gut’ is not a medical diagnosis, it does describe what happens to your gut barrier when your gut microbiome is out of balance and there is an increase in inflammation – your gut barrier becomes more permeable or ‘leaky’.
This increase in permeability allows potent immune stimulating compounds from bacteria in the gut to cross over into the blood stream which is not good news for your fertility. One of these compounds is lipopolysaccharide (LPS). LPS comes from the cell wall of certain bacteria and it is a potent driver of inflammation which reduces the quality of eggs and sperm, and uterine receptivity.
An increase in circulating levels of LPS contribute to inflammation in the ovary, reduce progesterone production , and impact embryo development and implantation. Endometriosis is associated with increased intestinal permeability and LPS .
Increasing the number of beneficial species in the gut strengthens the cells of the gut wall to reduce intestinal permeability, and lowering circulating immune stimulating compounds like LPS.
Prebiotics have been shown to increase beneficial bacteria living in the gut and reduce intestinal permeability. Our scientifically selected prebiotics in Fertile Gut can repair significant damage to the intestinal barrier, increase beneficial species in the microbiome and increase butyrate production! [6, 7]
High levels of oestrogen promote the growth of endometrial lesions outside of the uterus. They can also impact our nerves and upregulate factors that contribute to pain .
Our resident gut microbiota play a role in regulating oestrogen levels, and oestrogen can also regulate the gut microbiota. The collection of bacterial species that help regulate oestrogen is called our oestrobolome.
One way we get rid of oestrogen from the body is in faeces. How much oestrogen you excrete from your body, or how much you reabsorb back into your blood stream, is influenced by who is living in your gut.
If you have lots of bacteria that produce β-glucuronidase enzymes, these bacteria can breakdown (deconjugate) oestrogens in the gut so they are reabsorbed back into the circulation.
Almonds, konjac noodles and the specifically selected prebiotics of Microbiome Essentials can support a reduction in β-glucuronidase producing bacteria to reduce oestrogen [9-11].
Improve Your Gut Health for Endometriosis
While some bacteria can promote endometriosis, other beneficial bacteria can help dampen endometriosis. Nurturing your gut microbiome diversity is a proven strategy to reduce inflammation, strengthen your barrier and help regulate oestrogen to support endometriosis.
Are you nurturing a foundation for optimal reproductive health?
- Lin, Y.H., et al., Chronic Niche Inflammation in Endometriosis-Associated Infertility: Current Understanding and Future Therapeutic Strategies. Int J Mol Sci, 2018. 19(8).
- Azpiroz, M.A., et al., Potential biomarkers of infertility associated with microbiome imbalances. Am J Reprod Immunol, 2021. 86(4): p. e13438.
- Braun, D.P., et al., Monocyte-mediated enhancement of endometrial cell proliferation in women with endometriosis. Fertil Steril, 1994. 61(1): p. 78-84.
- Tremellen, K., et al., Metabolic endotoxaemia--a potential novel link between ovarian inflammation and impaired progesterone production. Gynecol Endocrinol, 2015. 31(4): p. 309-12.
- Vigano, D., et al., How is small bowel permeability in endometriosis patients? a case control pilot study. Gynecol Endocrinol, 2020. 36(11): p. 1010-1014.
- Shinde, T., et al., Synbiotic Supplementation Containing Whole Plant Sugar Cane Fibre and Probiotic Spores Potentiates Protective Synergistic Effects in Mouse Model of IBD. Nutrients, 2019. 11(4).
- Majima, A., et al., Real-time monitoring of trans-epithelial electrical resistance in cultured intestinal epithelial cells: the barrier protection of water-soluble dietary fiber. J Dig Dis, 2017. 18(3): p. 151-159.
- Chen, Q., et al., Estrogen receptors in pain modulation: cellular signaling. Biol Sex Differ, 2021. 12(1): p. 22.
- Rowland, I.R., et al., Effect of Bifidobacterium longum and inulin on gut bacterial metabolism and carcinogen-induced aberrant crypt foci in rats. Carcinogenesis, 1998. 19(2): p. 281-5.
- Liu, Z., et al., Prebiotic effects of almonds and almond skins on intestinal microbiota in healthy adult humans. Anaerobe, 2014. 26: p. 1-6.
- Wu, W.T., H.C. Cheng, and H.L. Chen, Ameliorative effects of konjac glucomannan on human faecal beta-glucuronidase activity, secondary bile acid levels and faecal water toxicity towards Caco-2 cells. Br J Nutr, 2011. 105(4): p. 593-600.
- McKinnon, B.D., et al., Altered differentiation of endometrial mesenchymal stromal fibroblasts is associated with endometriosis susceptibility. Commun Biol, 2022. 5(1): p. 600.