Associations Between Endometriosis and Gut Microbiota

Reprod Sci. 2021 Aug;28(8):2367-2377. doi: 10.1007/s43032-021-00506-5. Epub 2021 Mar 3.


The gut microbiota has been associated with many diseases, including endometriosis. However, very few studies have been conducted on this topic in human. This study aimed to investigate the association between endometriosis and gut microbiota. Women with endometriosis (N=66) were identified at the Department of Gynaecology and each patient was matched with three controls (N=198) from the general population. All participants answered questionnaires about socioeconomic data, medical history, and gastrointestinal symptoms and passed stool samples. Gut bacteria were analyzed using 16S ribosomal RNA sequencing, and in total, 58 bacteria were observed at genus level in both patients with endometriosis and controls. Comparisons of the microbiota between patients and controls and within the endometriosis cohort were performed. Both alpha and beta diversities were higher in controls than in patients. With the false discovery rate q<0.05, abundance of 12 bacteria belonging to the classes Bacilli, Bacteroidia, Clostridia, Coriobacteriia, and Gammaproteobacter differed significantly between patients and controls. Differences observed between patients with or without isolated ovarian endometriosis, involvement of the gastrointestinal tract, gastrointestinal symptoms, or hormonal treatment disappeared after calculation with false discovery rate. These findings indicate that the gut microbiota may be altered in endometriosis patients.

Keywords: Endometriosis; Gastrointestinal symptoms; Gut microbiota; Pathophysiology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bacteria / isolation & purification*
  • Endometriosis / microbiology*
  • Feces / microbiology
  • Female
  • Gastrointestinal Microbiome / physiology*
  • Humans
  • RNA, Ribosomal, 16S / analysis
  • Surveys and Questionnaires


  • RNA, Ribosomal, 16S