Gut Microbiome in Endometriosis: A Narrative Review of Human Evidence and Translational Challenges

Kamali Dolatabadi1, Fahimeh; Kamali Dolatabadi, Razie

doi:DOI:10.22088/crms.9.2.88

Volume 9, Issue 2 (2-2025) CRMS 2025, 9(2): 88-93 | Back to browse issues page

‎ DOI:10.22088/crms.9.2.88

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Kamali Dolatabadi1 F, Kamali Dolatabadi R. Gut Microbiome in Endometriosis: A Narrative Review of Human Evidence and Translational Challenges. , CRMS. 2025; 9 (2) : 13
URL: http://crms.mubabol.ac.ir/article-1-246-en.html

Gut Microbiome in Endometriosis: A Narrative Review of Human Evidence and Translational Challenges

Fahimeh Kamali Dolatabadi1

, Razie Kamali Dolatabadi ^*

2Department of Medicine, Najafabad Branch, Islamic Azad University, Najafabad, Iran , razie.kamaly91@gmail.com

Abstract: (36 Views)

The gut microbiome has been investigated as a possible contributor to the hormonal and inflammatory processes associated with endometriosis. However, human studies have produced inconsistent findings, and their clinical implications remain uncertain. This narrative review examines 15 publications addressing intestinal microbial composition, estrogen metabolism, immune associations, and microbiota-derived metabolites in endometriosis. Several small studies reported differences in microbial diversity or individual taxa, whereas a shotgun metagenomic study of 1,000 women found no significant differences in diversity, species, functional pathways, or estrobolome-related sequences after the relevant statistical analyses. Direct measurements of fecal β-glucuronidase activity have also failed to demonstrate a consistent disease-associated increase. Metabolomic research offers a complementary perspective: reduced fecal 4-hydroxyindole in affected women was accompanied by inhibitory effects on lesions and pain-related outcomes in preclinical models. These observations support further investigation but do not establish therapeutic efficacy in patients. Differences in participant selection, disease characteristics, sequencing methods, and statistical approaches limit comparisons across studies. Current evidence does not establish a reproducible gut microbial signature of endometriosis or a validated microbiome-based diagnostic test. Progress depends on clinically well-characterized cohorts, direct functional measurements, and independent validation of candidate biomarkers.

Article number: 13

Keywords: Endometriosis, Gut Microbiome, Estrobolome, Inflammation, Microbial Metabolites

Full-Text [PDF 1235 kb] (21 Downloads)

Type of Study: Review Article | Subject: میکروبیولوژی
Received: 2026/10/17 | Accepted: 2026/10/20 | Published: 2026/11/9