Current Research in Medical Sciences

en Gut Microbiome in Endometriosis: A Narrative Review of Human Evidence and Translational Challenges میکروبیولوژی میکروبیولوژی مروری Review Article 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. Endometriosis, Gut Microbiome, Estrobolome, Inflammation, Microbial Metabolites 88 93 http://crms.mubabol.ac.ir/browse.php?a_code=A-10-335-1&slc_lang=en&sid=1 Fahimeh Kamali Dolatabadi1 fahim.kamali92@gmail.com 0009-0000-8967-4797 No 1Department of Cell & Molecular Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran. Razie Kamali Dolatabadi razie.kamaly91@gmail.com 0000-0002-6741-7631 Yes 2Department of Medicine, Najafabad Branch, Islamic Azad University, Najafabad, Iran