A Surprising Cause of Endometriosis

Lightspring/Shutterstock

Endometriosis, a debilitating condition that affects fertility in many women, has no cure or clear preventative. However, a new study from Japan offers hope, as it has uncovered a possible link between endometriosis and a specific type of bacteria.

This finding implies that targeted antibiotic treatment could be key in curing this chronic ailment.

Endometriosis affects about 11 percent of women between the ages of 15 and 44 in the United States, and 10 percent of women globally. It can lead to severe pain because abnormal tissue growth occurs outside the uterus, affecting organs such as the ovaries and fallopian tubes.

Until now, available treatments have focused on symptom management using medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and painkillers such as acetaminophen, which carry their own health risks—including the possibility of infertility.

A Bacterium Linked to Endometriosis

By analyzing 76 healthy women and 79 women with endometriosis, the researchers found that 64 percent of those with endometriosis had Fusobacterium in their uterine lining, compared with only 7 percent of the healthy women. Fusobacterium is a naturally occurring type of bacteria commonly found in the mouth, gut, and vaginal region.

This bacterium has also been associated with colorectal cancer and inflammatory conditions such as periodontitis, or gum disease.

Researchers believe Fusobacterium is responsible for the physical changes seen in the disease. To confirm their findings, they infected female mice with Fusobacterium and treated them with antibiotics, specifically metronidazole and chloramphenicol. They observed that the treatment reduced the size and frequency of lesions commonly associated with endometriosis.

According to the study’s findings, Fusobacterium is a critical factor in stimulating the growth and aggregation of connective tissue cells called fibroblasts, which contribute to the formation of lesions in endometriosis.

Therefore, the study’s authors suggest that by targeting and eliminating Fusobacterium through antibiotic treatment, it may be possible to disrupt the processes that lead to the progression and symptoms of endometriosis, according to lead study author Dr. Yutaka Kondo, professor at the Graduate School of Medicine at Nagoya University.

“Our data provide a strong and novel rationale for targeting Fusobacterium as a nonhormonal antibiotic-based treatment for endometriosis,” Dr. Kondo said in a statement.

He said that eliminating this bacterium with antibiotics could be a practical approach when used for women who test positive for the infection, and that “such women could be easily identified by vaginal swab or uterus swab.”

The Most Common Theory on the Cause of Endometriosis

There are various theories regarding the cause of endometriosis, Dr. Adi Davidov, associate chair of obstetrics and gynecology at Northwell Staten Island University Hospital in New York, told The Epoch Times.

“The most prevalent theory is that of retrograde menstruation,” Dr. Davidov said. Women with anatomical obstructions that impede the normal flow of menstruation may have an increased risk of developing endometriosis, he said, adding that surgical correction of these anatomical obstructions, such as a transverse vaginal septum or an imperforate hymen, could potentially reduce risk.

Diagnosing endometriosis can be lengthy, often taking about 10 years from the onset of symptoms. Furthermore, the age at which symptoms begin can influence the time it takes to receive a proper diagnosis; the younger a woman is when symptoms begin, the longer it may take to diagnose the condition.

Common symptoms of endometriosis include excruciating menstrual cramps, abdominal or back pain during or between periods, pain during sexual intercourse, and heavy bleeding during menstrual periods.

Microbiome May Influence Endometriosis Risk

Researchers have been exploring the role of microbes in endometriosis. Ramakrishna Kommagani, an associate professor of pathology at Baylor College of Medicine with a doctorate in biomedical sciences, and his team recently researched the gut microbiome’s influence on endometriosis.

The gut microbiome is a community of microbes living inside the gut that are typically beneficial by aiding digestion and producing metabolites used by the body.

Using a mouse model, the researchers found evidence that suggested that an altered gut microbiome could play a crucial role in the progression of the disease. By using antibiotics to eliminate the gut microbiome in test animals, researchers observed that mice without a gut microbiome had smaller lesions than untreated mice.

Furthermore, when gut microbiome-free mice were implanted with gut microbes from mice with endometriosis, their lesions grew to a similar size as those in mice that still possessed their original microbiome.

Bowel issues like colitis and inflammatory bowel syndrome often coexist with endometriosis.

“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,” Mr. Kommagani said in a statement.

While this research didn’t establish a direct link between uterine microbes and endometriosis, the team identified a distinct signature of metabolites in the feces of mice with endometriosis. These metabolites, particularly quinic acid, enhanced cellular proliferation and lesion growth in endometriotic cells and mice.

These findings indicate that specific communities of microbiomes or their metabolites might contribute to the progression of endometriosis. Modifying the composition of microbiomes could potentially offer therapeutic benefits for treating endometriosis in humans. “We are currently investigating this possibility,” Mr. Kommagani said.