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<h1><span id="bcr_lblSubject">Could Endometriosis Be Caused by Bacteria?</span></h1>
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<span id="bcr_spanAuthor">Analysis by <a target="_blank" href="https://www.mercola.com/forms/background.htm">Dr. Joseph Mercola</a></span>
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<span id="bcr_rptStory_cslStory_0" cssclsas="story-list">A 2023 study found Fusobacterium could be linked to the development of endometriosis, which is a proliferation of uterine endometrial tissue in areas of the abdomen
outside the uterus</span>
</li>
<li>
<span id="bcr_rptStory_cslStory_1" cssclsas="story-list">The condition causes pain, heavy and irregular periods, fatigue and gastrointestinal symptoms during a menstrual period, such as diarrhea, constipation and pain with
urination or bowel movements</span>
</li>
<li>
<span id="bcr_rptStory_cslStory_2" cssclsas="story-list">Certain species of Fusobacterium are commonly found in the human gut and oral flora, but infections with other invasive species have been linked to a wide range of
clinical presentations from non-severe pharyngitis to life-threatening abscesses and sepsis</span>
</li>
<li>
<span id="bcr_rptStory_cslStory_3" cssclsas="story-list">Endometriosis places women at an increased risk of other health problems, including infertility, cancer, cutaneous melanoma, Non-Hodgkin's lymphoma, autoimmune diseases,
cardiovascular disease, asthma, obesity, migraine headaches and irritable bowel syndrome</span>
</li>
<li>
<span id="bcr_rptStory_cslStory_4" cssclsas="story-list">Women can take several steps to reduce the risk of developing endometriosis or help reduce the symptoms, including avoiding endocrine-disrupting chemicals as the
condition is hormone dependent, avoiding sugar to reduce inflammation and pain, and considering several nutraceuticals that may help reduce symptoms</span>
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<p>There is a good and a bad side to bacteria. One 2023 study<sup style="font-size: 10px;"><span id="edn1" data-hash="#ednref1">1</span></sup> published in Science Translational Medicine revealed data suggesting one genus of an
anaerobic, gram-negative bacteria,<sup style="font-size: 10px;"><span id="edn2" data-hash="#ednref2">2</span></sup> Fusobacterium, plays an influential role in the development of endometriosis. This genus of bacteria has species
that live symbiotically with humans and others that develop invasive infections.</p>
<p>The inappropriate use of antibiotics and bacterial infections has culminated in the "greatest public health challenge of our time"<sup style="font-size: 10px;"><span id="edn3" data-hash="#ednref3">3</span></sup> — antimicrobial
resistance. One important focus of attaining and maintaining optimal health is supporting a balanced gut microbiome. When bacteria develop the ability to avoid the drugs designed to kill them, resistant infections can proliferate
and become difficult or impossible to treat.</p>
<p>Your gut microbiome is a major contributor to a wide range of physical, mental and emotional health conditions. Research links gut microbial dysbiosis to obesity, Type 2 diabetes, cardiovascular
disease,<sup style="font-size: 10px;"><span id="edn4" data-hash="#ednref4">4</span></sup> athletic performance,<sup style="font-size: 10px;"><span id="edn5" data-hash="#ednref5">5</span></sup> cognitive
impairment,<sup style="font-size: 10px;"><span id="edn6" data-hash="#ednref6">6</span></sup> depression and anxiety.<sup style="font-size: 10px;"><span id="edn7" data-hash="#ednref7">7</span></sup> It should then come as no surprise
that bacteria may play a role, regardless of how significant, in many of the prevalent chronic health conditions that plague society.</p>
<p>The film, "The Invisible Extinction,"<sup style="font-size: 10px;"><span id="edn8" data-hash="#ednref8">8</span></sup> highlights the work of microbiologists Dr. Martin Blaser and Gloria Dominguez-Bello — a husband-wife team — who
warn that the <a href="https://takecontrol.substack.com/p/endangered-human-microbiome" target="_blank">human microbiome is endangered</a>, putting human health at risk.</p>
<p>As data indicating the significance of a healthy microbiome to overall health continues to mount, researchers are also identifying ways in which harmful bacteria play a role in noninfectious disease development. And, one particular
bacterial infection associated with endometriosis, Fusobacterium, may suggest a potential treatment pathway for this painful disorder.<sup style="font-size: 10px;"><span id="edn9" data-hash="#ednref9">9</span></sup></p>
<h2>Could This Bacteria Trigger Endometriosis?</h2>
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<p>The 2023 study<sup style="font-size: 10px;"><span id="edn10" data-hash="#ednref10">10</span></sup> found that Fusobacterium, a bacterial type that's commonly found in the human gut and oral flora, may be linked to endometriosis.
The study included 155 women in Japan<sup style="font-size: 10px;"><span id="edn11" data-hash="#ednref11">11</span></sup> and found 64% of women presenting with endometriosis had Fusobacterium within ovarian endometriotic lesions.
However, less than 10% of women without endometriosis had the Fusobacterium in their endometrium.<sup style="font-size: 10px;"><span id="edn12" data-hash="#ednref12">12</span></sup></p>
<p>The researchers used an animal model and inoculated Fusobacterium into mice which then increased myofibroblasts and the weight and number of endometriotic lesions. The mice were treated with antibiotics and researchers found this
could, in large part, not only prevent endometriosis from developing, but help reduce the endometriotic lesions that were already established.</p>
<p>The researchers believe the data support a potential mechanism for the development of endometriosis and suggest it could be an approach to treating the
disease.<sup style="font-size: 10px;"><span id="edn13" data-hash="#ednref13">13</span></sup></p>
<p>In addition to evaluating for the presence of Fusobacterium within human endometrial tissue and testing an animal model, the researchers also used cell culture experiments to find that the bacteria initiated a substance called
TGF-beta, which appeared to activate normally dormant cells.</p>
<p>Although certain species of Fusobacterium live symbiotically within the oral and gut microflora, this species of Fusobacterium is invasive and has been linked to other infections and
diseases.<sup style="font-size: 10px;"><span id="edn14" data-hash="#ednref14">14</span></sup> Although the infections with Fusobacterium are
uncommon,<sup style="font-size: 10px;"><span id="edn15" data-hash="#ednref15">15</span></sup> they tend to infect younger and older individuals and cause a wide range of clinical symptoms from non-severe pharyngitis to
life-threatening abscesses and sepsis.</p>
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<h2>What Is Endometriosis?</h2>
<p>The word "endometriosis" is derived from the name of the tissue that lines the uterus, which is the endometrium. This lining is what the body releases with each menstrual cycle. Each month, the body grows a new endometrium in
preparation for a potential pregnancy. Endometriosis occurs when this tissue grows in areas of the abdomen outside of the uterus.</p>
<p>According to Johns Hopkins Medicine, the condition affects up to 10% of women.<sup style="font-size: 10px;"><span id="edn16" data-hash="#ednref16">16</span></sup> The endometrial tissue most often grows on or around the
reproductive organs, such as the ovaries, fallopian tubes, space between the uterus and the rectum, or the lining of the pelvic cavity. Less frequently, it can also grow around the bladder, intestines, rectum and stomach.</p>
<p>The condition increases pain associated with menstrual cramps and can cause pain during or after sex. Women may also experience heavy or irregular periods, fatigue and gastrointestinal symptoms during a menstrual period such as
diarrhea, constipation and pain with urination or bowel movements.</p>
<p>Although the condition has no known cause, data does show certain factors increase the risk, including starting menstruation before age 11, a family history of endometriosis and periods that last more than 7 days. Although in many
cases, a diagnosis of endometriosis begins with severe symptoms, some women can have endometriotic lesions outside the uterus but have no symptoms.<sup style="font-size: 10px;"><span id="edn17" data-hash="#ednref17">17</span></sup>
</p>
<p>While data from the featured study is encouraging, as it helps to at least point to a potential trigger, it's important to note that endometriosis is likely multifactorial and may have cultural or environmental differences. A 2021
study<sup style="font-size: 10px;"><span id="edn18" data-hash="#ednref18">18</span></sup> published in Reproductive Sciences evaluated a group of 371 fertile women with endometriosis, 175 from China and 196 from Italy. Symptoms and
quality of life were compared, which revealed significant differences between the two groups.</p>
<p>Italian women presented with symptoms at a younger age, more frequently with severe pain, were more often diagnosed with deep infiltrating endometriosis and had more systemic comorbidities at the time of diagnosis than women from
China. Scores on tests also showed the Italian group of women had worse health-related quality of life.</p>
<p>In the group of Chinese women, there was less pain, diagnosis at an older age, ovarian and superficial endometriosis and better quality of life scores. The researchers suggested that the differences may be related to ethnicity,
healthcare system or social and cultural background.<sup style="font-size: 10px;"><span id="edn19" data-hash="#ednref19">19</span></sup></p>
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<h2>Endometriosis and Comorbidities</h2>
<p>Endometriosis is debilitating. According to Science Alert,<sup style="font-size: 10px;"><span id="edn20" data-hash="#ednref20">20</span></sup> women in the U.K. often wait an average of 7.5 years before seeing their physician for a
diagnosis and Yale Medicine<sup style="font-size: 10px;"><span id="edn21" data-hash="#ednref21">21</span></sup> estimates that women in the U.S. may experience symptoms for 10 years before getting a proper diagnosis.</p>
<p>Unfortunately, this places these women at risk of more health problems, including infertility. In some cases, endometriosis causes complete infertility, but in other cases, fertility may not be affected.
Research<sup style="font-size: 10px;"><span id="edn22" data-hash="#ednref22">22</span></sup> also suggests that women with endometriosis have a higher risk of pregnancy-related complications, including preterm delivery, miscarriage,
preeclampsia, bowel perforation and uterine rupture.</p>
<p>When left untreated, endometriosis not only leads to infertility, but other organ damage. A 2015 systematic review<sup style="font-size: 10px;"><span id="edn23" data-hash="#ednref23">23</span></sup> of the literature identified
studies that looked at the association between endometriosis and specific diseases.</p>
<p>They found increasing evidence that women with endometriosis have a higher risk of several chronic diseases, suggesting that the condition is not harmless with respect to long-term health. According to this review, women with
endometriosis had a "higher risk of ovarian and breast cancers, cutaneous melanoma, asthma, and some autoimmune, cardiovascular and atopic diseases, and at decreased risk of cervical
cancer."<sup style="font-size: 10px;"><span id="edn24" data-hash="#ednref24">24</span></sup></p>
<p>In a separate article,<sup style="font-size: 10px;"><span id="edn25" data-hash="#ednref25">25</span></sup> one of the scientists postulated potential explanations for the associations, including that studies may have had a
methodological bias. Other explanations included the potential that endometriosis induces physiological changes that increase the risk of chronic disease, that women with endometriosis share specific risk factors for chronic
disease, or that the treatment for endometriosis could increase the risk of some chronic diseases.</p>
<p>Analysis of data from Taiwan<sup style="font-size: 10px;"><span id="edn26" data-hash="#ednref26">26</span></sup> identified similar associations between endometriosis and chronic diseases. In this population, the researchers also
found an association with irritable bowel syndrome, migraine headaches, pelvic inflammatory disease, obesity, chronic liver disease, cardiovascular disease, diabetes, rheumatoid arthritis and chronic renal disease.</p>
<p>A 2023 study<sup style="font-size: 10px;"><span id="edn27" data-hash="#ednref27">27</span></sup> published in the journal Nature Genetics may help explain the comorbidity with other inflammatory and pain-related conditions. In a
genome-wide association meta-analysis of European and East Asian participants, the researchers:</p>
<blockquote>
<p><em>"… observed significant genetic correlations between endometriosis and 11 pain conditions, including migraine, back and multisite chronic pain (MCP), as well as inflammatory conditions, including asthma and
osteoarthritis."</em></p>
</blockquote>
<p>The severity of the symptoms can affect mental health<sup style="font-size: 10px;"><span id="edn28" data-hash="#ednref28">28</span></sup> and may compromise social relationships, which in turn influences support systems. Depression
and anxiety can also amplify the perception of pain. In one study,<sup style="font-size: 10px;"><span id="edn29" data-hash="#ednref29">29</span></sup> researchers estimated that at least one-third of women with endometriosis suffer
from depression and anxiety.</p>
<h2>Reducing Symptoms of Endometriosis</h2>
<p>Insulin sensitivity may also play a role in endometriosis. A 2019 review<sup style="font-size: 10px;"><span id="edn30" data-hash="#ednref30">30</span></sup> looked at the likelihood of the coexistence of Type 1 diabetes and
endometriosis, including the prospect that therapeutic strategies could help reduce complications. While Type 1 diabetes is an autoimmune disease, endometriosis is not.</p>
<p>However, according to the paper, they share similar pathophysiological pathways, including an association with chronic inflammation and an overactive immune response. A 2002
study<sup style="font-size: 10px;"><span id="edn31" data-hash="#ednref31">31</span></sup> also showed women with endometriosis more frequently had mechanical dysfunction in the gastrointestinal system and reactive hypoglycemia with
normal insulin levels.</p>
<p>According to the researchers, the nerve dysfunction found in women with endometriosis was identical to that found in individuals with insulin resistance and resulted in debilitating gastrointestinal symptoms. In addition to
strategies that improve insulin sensitivity and reduce resistance, women with endometriosis may consider addressing other factors that contribute to symptoms of endometriosis, such as:</p>
<div class="indent">
<p><strong><span class="bullet">• </span>Avoiding endocrine disruptors —</strong> Endometriosis is hormone dependent, and data has linked exposure to environmental endocrine disrupting chemicals (EDCs) with the development of
endometriosis. A 2023 study<sup style="font-size: 10px;"><span id="edn32" data-hash="#ednref32">32</span></sup> looked at epidemiological and experimental data of four EDCs and found:</p>
<blockquote>
<p><em>"The available information strongly indicates that environmental exposure to EDCs such as PCBs, dioxins, BPA, and phthalates individually or collectively contribute to the pathophysiology of endometriosis."</em></p>
</blockquote>
<p>One commonly used EDC is oxybenzone, found in many sunscreen formulations. The Environmental Working Group (EWG) calls oxybenzone "the most worrisome sunscreen active
ingredient,"<sup style="font-size: 10px;"><span id="edn33" data-hash="#ednref33">33</span></sup> as the chemical is readily absorbed through the skin, is associated with skin reactions and has demonstrated hormone-disrupting
properties.</p>
<p>A 2012 study<sup style="font-size: 10px;"><span id="edn34" data-hash="#ednref34">34</span></sup> associated benzophenone, the class of drugs to which oxybenzone
belongs,<sup style="font-size: 10px;"><span id="edn35" data-hash="#ednref35">35</span></sup> as an EDC that has a high likelihood of increasing the risk of endometriosis. EDC chemicals are found in many everyday products,
including pesticides, plastics and food storage materials, and antibacterial soaps.<sup style="font-size: 10px;"><span id="edn36" data-hash="#ednref36">36</span></sup></p>
<p><strong><span class="bullet">• </span>Avoiding sugar —</strong> Dysregulated blood sugar has a significant influence on endometriosis as it promotes an inflammatory response in the
body,<sup style="font-size: 10px;"><span id="edn37" data-hash="#ednref37">37</span></sup> which may contribute to a flare-up of the disease and raise pain levels. As blood sugar rises, cortisol can also rise which lowers
progesterone levels and sets the stage for higher levels of estrogen.<sup style="font-size: 10px;"><span id="edn38" data-hash="#ednref38">38</span></sup></p>
<p><strong><span class="bullet">• </span>Considering physical activity —</strong> Physical activity and exercise is an important factor in attaining and maintaining optimal health. Yet, for women with endometriosis, they may want to
consider physical activity a prescription to help lower inflammation and painful symptoms. While the literature examining endometriosis is not conclusive, data does reveal that physical activity helps lower the inflammatory
response.<sup style="font-size: 10px;"><span id="edn39" data-hash="#ednref39">39</span></sup></p>
<p>One review of the literature<sup style="font-size: 10px;"><span id="edn40" data-hash="#ednref40">40</span></sup> was unable to find enough quality studies to produce a quantitative meta-analysis, but did identify a couple studies
showing activity improved pain intensity and decreased stress levels. The researchers suggested future high-quality randomized controlled trials were necessary to determine if physical activity improved symptoms and quality of
life.</p>
<p>A 2023 study<sup style="font-size: 10px;"><span id="edn41" data-hash="#ednref41">41</span></sup> in the International Journal Gynecology and Obstetrics, reviewed the benefits of physical therapy in women with endometriosis, doing
a meta-analysis on six studies that evaluated pain intensity and quality of life measures. The data show these non-pharmacological therapies "are a therapeutic option for women with endometriosis for improving pain intensity and
physical function."</p>
<p><strong><span class="bullet">• </span>Considering supplements —</strong> Women with endometriosis may also consider nutraceuticals that have demonstrated a beneficial effect against the pain and symptoms of endometriosis.
N-acetylcysteine (NAC), chasteberry and melatonin may all offer some relief.</p>
<p>In a 2013 Italian study,<sup style="font-size: 10px;"><span id="edn42" data-hash="#ednref42">42</span></sup> women who took 600 mg of NAC three times a day for three consecutive days per week, for three months, saw such
significant improvement that half of the treatment group were able to cancel their surgeries. Eight of the 47 women in the intervention group had complete remission. The researchers concluded
that:<sup style="font-size: 10px;"><span id="edn43" data-hash="#ednref43">43</span></sup></p>
<blockquote>
<p><em>"Our results are better than those reported after hormonal treatments … NAC actually represents a simple effective treatment for endometriosis, without side effects, and a suitable approach for women desiring a
pregnancy."</em></p>
</blockquote>
<p>Chasteberry is known as "the woman’s herb," and has a long history of use in female fertility and hormonal health. A leaf decoction has demonstrated a reduction in symptoms of endometriosis within clinical practice and reduction
in endometrial cyst size.<sup style="font-size: 10px;"><span id="edn44" data-hash="#ednref44">44</span></sup> Chasteberry may also help reduce inflammation and balance reproductive
hormones.<sup style="font-size: 10px;"><span id="edn45" data-hash="#ednref45">45</span></sup></p>
<p>Chasteberry may help increase progesterone production, which affects the luteal phase of the menstrual cycle, the time from ovulation until bleeding starts. These issues are often linked to menstrual irregularities, including
endometriosis.</p>
<p>Melatonin has also shown some promise for pain control. In one study,<sup style="font-size: 10px;"><span id="edn46" data-hash="#ednref46">46</span></sup> 10 mg per day of
<a href="https://takecontrol.substack.com/p/is-it-ok-to-take-melatonin-every-night" target="_blank">melatonin</a> helped decrease pain by 39.8% and dysmenorrhea by 38.01%.</p>
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<div class="gdpr-container" style="display: none;">
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<p><a role="button" name="close" aria-label="Close button"><i class="fa fa-times" role="img"></i></a></p>
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</div>
<input type="hidden" name="ctl00$cdsf$hdnDate" id="cdsf_hdnDate">
<input type="hidden" name="ctl00$cdsf$hdnEnddatetime" id="cdsf_hdnEnddatetime">
<style>
.countdown#cdsf_divcountdown {
background: #2a2a72 !important
}
.countdown .countdown-text p {
text-align: center;
font-size: 29px;
}
.countdown .countdown-button a {
font-weight: bold;
max-width: 180px;
}
.countdown .countdown-timer {
width: 30%;
padding-right: 0px !important;
}
.countdown .countdown-text {
width: 52%
}
.countdown .countdown-text a:hover {
text-decoration: none;
color: #e3e3e3;
border-color: #e3e3e3;
}
.countdown-button {
width: 25% !important
}
.countdown-close {
width: 3% !important
}
.countdown-text-img {
padding-left: 16px;
}
@media screen and (max-width: 1199px) {
.countdown#cdsf_divcountdown {
display: block;
background: #2a2a72 !important
}
}
@media screen and (max-width: 1100px) {
.countdown .countdown-text p {
font-size: 20px;
line-height: 24px;
}
}
@media screen and (min-width: 765px) and (max-width: 989px) {
.countdown .countdown-timer {
font-size: 30px;
width: 25%
}
.countdown .countdown-timer label {
font-size: 11px;
line-height: 18px
}
.countdown .countdown-text {
width: 42%
}
.countdown-button {
width: 25% !important
}
}
@media screen and (max-width: 764px) {
.countdown .countdown-text p {
font-size: 20px;
line-height: 26px;
}
.countdown .countdown-timer {
display: none
}
.countdown .countdown-text {
width: 95%
}
.countdown-button {
width: 35% !important
}
.countdown-close {
width: 5% !important
}
.countdown .max-width-collapsed {
width: 100%;
display: table;
}
.countdown-text-img {
padding-left: 0;
}
}
.countdown-text-wrapper {
display: inline-flex;
align-items: center;
vertical-align: bottom;
}
.content-text-copy {
font-size: 14px;
line-height: 18px;
padding: 10px 12px 10px 20px !important;
text-align: left;
}
.countdown-btn-mob {
display: none;
}
@media screen and (max-width: 520px) {
.countdown .countdown-text {
width: 95%
}
.countdown-button {
width: 35% !important
}
.countdown-close {
width: 5% !important
}
.countdown .countdown-button a {
font-size: 16px;
padding: 8px 20px;
}
.countdown .countdown-text p {
font-size: 18px;
line-height: 25px;
padding-left: 10px;
padding-right: 10px;
}
}
@media screen and (max-width: 400px) {
.countdown .countdown-button a {
font-size: 14px;
padding: 8px 10px;
}
.countdown .countdown-text p {
font-size: 15px;
line-height: 20px;
padding-left: 5px;
padding-right: 5px;
}
.countdown-text-img {
width: 120px;
}
}
.has-countdown .top-button {
bottom: 95px !important;
}
@media screen and (max-width: 1199px) {
.has-countdown {
margin-bottom: 150px;
}
.has-countdown .top-button {
bottom: 180px !important;
}
}
@media screen and (max-width: 690px) {
.has-countdown {
margin-bottom: 165px;
}
}
@media screen and (max-width: 400px) {
.has-countdown {
margin-bottom: 150px;
}
}
/** STICKY WITH IMAGE **/
@media screen and (max-width: 989px) {
.countdown-button {
display: none !important;
}
.countdown-btn-mob {
display: block !important;
width: 75px;
text-align: center;
margin: 0 auto;
font-size: 13px;
border-bottom: 1px solid #fff;
}
}
/** STICKY WITHOUT IMAGE
@media screen and (max-width: 764px) {
.countdown-button {display: none !important;}
.countdown-btn-mob {display: block !important;width: 75px; text-align: center;margin: 0 auto;font-size: 13px;border-bottom: 1px solid #fff;}
}
**/
</style>
<script type="text/javascript">
function lvwallMarginbottom() {
var stickycountdownHeight = $('#cdsf_divcountdown');
$('.has-countdown #rrIframe').css({
marginBottom: stickycountdownHeight.outerHeight()
});
}
$(window).on('resize', function() {
lvwallMarginbottom();
});
//$(document).ready(function () { lvwallMarginbottom(); });
</script>
<div id="cdsf_divcountdown" class="countdown" style="display: none;">
<div class="max-width-collapsed">
<div class="countdown-timer">
<div class="days">
<span id="cdsf_lblDays">NaN</span><label id="lbldayslbl">Days</label>
</div>
<span id="spndayscolon" class="colon">:</span>
<div class="hours">
<span id="cdsf_lblHours">NaN</span><label id="lblhrslbl">Hours</label>
</div>
<span id="spnhrscolon" class="colon">:</span>
<div class="minutes">
<span id="cdsf_lblMinutes">NaN</span><label id="lblminlbl">Minutes</label>
</div>
<span id="spnmincolon" class="colon">:</span>
<div class="seconds">
<span id="cdsf_lblSeconds">NaN</span><label id="lblseclbl">Seconds</label>
</div>
</div>
<div class="countdown-text">
<span id="cdsf_lblstickyfooternote"></span>
</div>
<div class="countdown-button">
<span id="cdsf_lblstickyButtonHTML"></span>
</div>
<div class="countdown-close">
<a alt="alt"><i class="fa fa-times" aria-hidden="true" id="btnclose" onclick="if (!window.__cfRLUnblockHandlers) return false; onclickstickyfooter();"></i></a>
</div>
</div>
</div>
<div data-jsid="socialIconMobile" class="social-icons-mobile">
<style type="text/css">
@media screen and (max-width: 1199px) {
.top-button {
bottom: 90px
}
.footer-seal {
margin-bottom: 70px
}
.gdpr-container {
margin: 0 8px 88px
}
}
@media screen and (min-width: 768px) {
.dontprint.social-mobile {
width: 65%
}
.social-mobile {
width: 65% !important
}
}
@media screen and (max-width: 479px) {
.dontprint.social-mobile {
width: 45%
}
.post-nav-mobile {
width: 25% !important
}
.breaking-news-mobile {
width: 30% !important
}
}
.social-mobile.notdevice .social-btn {
width: 24%
}
.social-icons-mobile {
padding: 15px 9px;
width: 100%;
box-shadow: 0 2px 10px 1px #d5d5d5;
border: 0;
background: #F9F9F9
}
.social-mobile li {
width: 22%;
font-family: inherit;
list-style: none outside none;
display: inline-block;
text-align: center;
vertical-align: middle;
line-height: 20px;
}
.social-mobile li a {
width: 35px;
height: 35px;
background-repeat: no-repeat !important;
display: inline-block !important;
border-radius: 0 !important;
background-position: center !important
}
.social-mobile a:hover {
cursor: pointer
}
.social-mobile .share-count-total {
color: #0869BD;
font-size: 17px;
font-weight: 600;
text-align: left;
width: 22%;
padding-top: 10px;
display: none
}
.social-mobile li.fb-icon {
width: 15% !important;
}
.social-mobile li.fb-icon a {
width: 18px !important;
}
@media screen and (min-width: 480px) {
.social-mobile .share-count-total {
font-size: 15px
}
}
.social-mobile .share-count-total span[data-share-counter] {
display: block;
margin: 0 auto;
text-align: center
}
.social-mobile .share-count-total::after {
content: "Shares";
font-size: 11px;
color: #868686;
display: block;
text-align: center;
margin-top: 0
}
.social-mobile .social-btn {
width: 22%
}
.social-mobile .breaking-news {
width: 24%
}
.social-mobile .social-btn>a,
.social-mobile .social-btn>i {
display: block;
padding: 10px 5px;
border-radius: 10px;
text-transform: uppercase;
font-size: 11px;
line-height: 12px;
font-weight: 700
}
.social-mobile .social-btn>a:before,
.social-mobile .social-btn>i:before {
font-family: FontAwesome;
font-size: 24px
}
.social-mobile .social-btn[data-social-btn="breakingnews"]>a {
background: #AF1B30;
color: #fff;
border: 2px solid #AF1B30;
border-radius: 10px;
background: #AF1B30
}
.social-mobile .social-btn[data-social-btn="facebook"]>a {
color: #226CAB;
background: none;
border-radius: 10px;
border: 2px solid #226CAB;
padding: 16px 0 12px
}
.social-mobile .social-btn[data-social-btn="share-count"]>a {
color: #226CAB;
background: none;
border-radius: 10px;
border: 2px solid #226CAB;
font-size: 16px
}
.share-text {
display: block;
font-size: 11px
}
.social-icons-mobile .social-mobile.hasnopdf li {
width: 33%;
}
.social-icons-mobile span[data-social-btn="pdf"] {
width: 22%;
font-family: inherit;
list-style: none outside none;
display: inline-block;
text-align: center;
vertical-align: middle;
line-height: 20px;
}
.social-icons-mobile span[data-social-btn="pdf"] a {
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width: 35px;
height: 35px;
background-repeat: no-repeat !important;
display: inline-block !important;
border-radius: 0px !important;
background-position: center;
}
.social-icons-mobile li.mailto-icon a {
background: url('data:image/svg+xml,<svg width="25" height="19" viewBox="0 0 25 19" fill="none" xmlns="http://www.w3.org/2000/svg"><path d="M24.5264 6.19141C24.7168 6.04004 25 6.18164 25 6.4209V16.4062C25 17.7002 23.9502 18.75 22.6562 18.75H2.34375C1.0498 18.75 0 17.7002 0 16.4062V6.42578C0 6.18164 0.27832 6.04492 0.473633 6.19629C1.56738 7.0459 3.01758 8.125 7.99805 11.7432C9.02832 12.4951 10.7666 14.0771 12.5 14.0674C14.2432 14.082 16.0156 12.4658 17.0068 11.7432C21.9873 8.125 23.4326 7.04102 24.5264 6.19141ZM12.5 12.5C13.6328 12.5195 15.2637 11.0742 16.084 10.4785C22.5635 5.77637 23.0566 5.36621 24.5508 4.19434C24.834 3.97461 25 3.63281 25 3.27148V2.34375C25 1.0498 23.9502 0 22.6562 0H2.34375C1.0498 0 0 1.0498 0 2.34375V3.27148C0 3.63281 0.166016 3.96973 0.449219 4.19434C1.94336 5.36133 2.43652 5.77637 8.91602 10.4785C9.73633 11.0742 11.3672 12.5195 12.5 12.5Z" fill="%23313131"/></svg>')
}
.social-icons-mobile li.sms-icon a {
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COULD ENDOMETRIOSIS BE CAUSED BY BACTERIA?
Analysis by Dr. Joseph Mercola
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* February 23, 2024Download PDF
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STORY AT-A-GLANCE
* A 2023 study found Fusobacterium could be linked to the development of
endometriosis, which is a proliferation of uterine endometrial tissue in
areas of the abdomen outside the uterus
* The condition causes pain, heavy and irregular periods, fatigue and
gastrointestinal symptoms during a menstrual period, such as diarrhea,
constipation and pain with urination or bowel movements
* Certain species of Fusobacterium are commonly found in the human gut and oral
flora, but infections with other invasive species have been linked to a wide
range of clinical presentations from non-severe pharyngitis to
life-threatening abscesses and sepsis
* Endometriosis places women at an increased risk of other health problems,
including infertility, cancer, cutaneous melanoma, Non-Hodgkin's lymphoma,
autoimmune diseases, cardiovascular disease, asthma, obesity, migraine
headaches and irritable bowel syndrome
* Women can take several steps to reduce the risk of developing endometriosis
or help reduce the symptoms, including avoiding endocrine-disrupting
chemicals as the condition is hormone dependent, avoiding sugar to reduce
inflammation and pain, and considering several nutraceuticals that may help
reduce symptoms
There is a good and a bad side to bacteria. One 2023 study1 published in Science
Translational Medicine revealed data suggesting one genus of an anaerobic,
gram-negative bacteria,2 Fusobacterium, plays an influential role in the
development of endometriosis. This genus of bacteria has species that live
symbiotically with humans and others that develop invasive infections.
The inappropriate use of antibiotics and bacterial infections has culminated in
the "greatest public health challenge of our time"3 — antimicrobial resistance.
One important focus of attaining and maintaining optimal health is supporting a
balanced gut microbiome. When bacteria develop the ability to avoid the drugs
designed to kill them, resistant infections can proliferate and become difficult
or impossible to treat.
Your gut microbiome is a major contributor to a wide range of physical, mental
and emotional health conditions. Research links gut microbial dysbiosis to
obesity, Type 2 diabetes, cardiovascular disease,4 athletic performance,5
cognitive impairment,6 depression and anxiety.7 It should then come as no
surprise that bacteria may play a role, regardless of how significant, in many
of the prevalent chronic health conditions that plague society.
The film, "The Invisible Extinction,"8 highlights the work of microbiologists
Dr. Martin Blaser and Gloria Dominguez-Bello — a husband-wife team — who warn
that the human microbiome is endangered, putting human health at risk.
As data indicating the significance of a healthy microbiome to overall health
continues to mount, researchers are also identifying ways in which harmful
bacteria play a role in noninfectious disease development. And, one particular
bacterial infection associated with endometriosis, Fusobacterium, may suggest a
potential treatment pathway for this painful disorder.9
COULD THIS BACTERIA TRIGGER ENDOMETRIOSIS?
The 2023 study10 found that Fusobacterium, a bacterial type that's commonly
found in the human gut and oral flora, may be linked to endometriosis. The study
included 155 women in Japan11 and found 64% of women presenting with
endometriosis had Fusobacterium within ovarian endometriotic lesions. However,
less than 10% of women without endometriosis had the Fusobacterium in their
endometrium.12
The researchers used an animal model and inoculated Fusobacterium into mice
which then increased myofibroblasts and the weight and number of endometriotic
lesions. The mice were treated with antibiotics and researchers found this
could, in large part, not only prevent endometriosis from developing, but help
reduce the endometriotic lesions that were already established.
The researchers believe the data support a potential mechanism for the
development of endometriosis and suggest it could be an approach to treating the
disease.13
In addition to evaluating for the presence of Fusobacterium within human
endometrial tissue and testing an animal model, the researchers also used cell
culture experiments to find that the bacteria initiated a substance called
TGF-beta, which appeared to activate normally dormant cells.
Although certain species of Fusobacterium live symbiotically within the oral and
gut microflora, this species of Fusobacterium is invasive and has been linked to
other infections and diseases.14 Although the infections with Fusobacterium are
uncommon,15 they tend to infect younger and older individuals and cause a wide
range of clinical symptoms from non-severe pharyngitis to life-threatening
abscesses and sepsis.
WHAT IS ENDOMETRIOSIS?
The word "endometriosis" is derived from the name of the tissue that lines the
uterus, which is the endometrium. This lining is what the body releases with
each menstrual cycle. Each month, the body grows a new endometrium in
preparation for a potential pregnancy. Endometriosis occurs when this tissue
grows in areas of the abdomen outside of the uterus.
According to Johns Hopkins Medicine, the condition affects up to 10% of women.16
The endometrial tissue most often grows on or around the reproductive organs,
such as the ovaries, fallopian tubes, space between the uterus and the rectum,
or the lining of the pelvic cavity. Less frequently, it can also grow around the
bladder, intestines, rectum and stomach.
The condition increases pain associated with menstrual cramps and can cause pain
during or after sex. Women may also experience heavy or irregular periods,
fatigue and gastrointestinal symptoms during a menstrual period such as
diarrhea, constipation and pain with urination or bowel movements.
Although the condition has no known cause, data does show certain factors
increase the risk, including starting menstruation before age 11, a family
history of endometriosis and periods that last more than 7 days. Although in
many cases, a diagnosis of endometriosis begins with severe symptoms, some women
can have endometriotic lesions outside the uterus but have no symptoms.17
While data from the featured study is encouraging, as it helps to at least point
to a potential trigger, it's important to note that endometriosis is likely
multifactorial and may have cultural or environmental differences. A 2021
study18 published in Reproductive Sciences evaluated a group of 371 fertile
women with endometriosis, 175 from China and 196 from Italy. Symptoms and
quality of life were compared, which revealed significant differences between
the two groups.
Italian women presented with symptoms at a younger age, more frequently with
severe pain, were more often diagnosed with deep infiltrating endometriosis and
had more systemic comorbidities at the time of diagnosis than women from China.
Scores on tests also showed the Italian group of women had worse health-related
quality of life.
In the group of Chinese women, there was less pain, diagnosis at an older age,
ovarian and superficial endometriosis and better quality of life scores. The
researchers suggested that the differences may be related to ethnicity,
healthcare system or social and cultural background.19
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ENDOMETRIOSIS AND COMORBIDITIES
Endometriosis is debilitating. According to Science Alert,20 women in the U.K.
often wait an average of 7.5 years before seeing their physician for a diagnosis
and Yale Medicine21 estimates that women in the U.S. may experience symptoms for
10 years before getting a proper diagnosis.
Unfortunately, this places these women at risk of more health problems,
including infertility. In some cases, endometriosis causes complete infertility,
but in other cases, fertility may not be affected. Research22 also suggests that
women with endometriosis have a higher risk of pregnancy-related complications,
including preterm delivery, miscarriage, preeclampsia, bowel perforation and
uterine rupture.
When left untreated, endometriosis not only leads to infertility, but other
organ damage. A 2015 systematic review23 of the literature identified studies
that looked at the association between endometriosis and specific diseases.
They found increasing evidence that women with endometriosis have a higher risk
of several chronic diseases, suggesting that the condition is not harmless with
respect to long-term health. According to this review, women with endometriosis
had a "higher risk of ovarian and breast cancers, cutaneous melanoma, asthma,
and some autoimmune, cardiovascular and atopic diseases, and at decreased risk
of cervical cancer."24
In a separate article,25 one of the scientists postulated potential explanations
for the associations, including that studies may have had a methodological bias.
Other explanations included the potential that endometriosis induces
physiological changes that increase the risk of chronic disease, that women with
endometriosis share specific risk factors for chronic disease, or that the
treatment for endometriosis could increase the risk of some chronic diseases.
Analysis of data from Taiwan26 identified similar associations between
endometriosis and chronic diseases. In this population, the researchers also
found an association with irritable bowel syndrome, migraine headaches, pelvic
inflammatory disease, obesity, chronic liver disease, cardiovascular disease,
diabetes, rheumatoid arthritis and chronic renal disease.
A 2023 study27 published in the journal Nature Genetics may help explain the
comorbidity with other inflammatory and pain-related conditions. In a
genome-wide association meta-analysis of European and East Asian participants,
the researchers:
> "… observed significant genetic correlations between endometriosis and 11 pain
> conditions, including migraine, back and multisite chronic pain (MCP), as well
> as inflammatory conditions, including asthma and osteoarthritis."
The severity of the symptoms can affect mental health28 and may compromise
social relationships, which in turn influences support systems. Depression and
anxiety can also amplify the perception of pain. In one study,29 researchers
estimated that at least one-third of women with endometriosis suffer from
depression and anxiety.
REDUCING SYMPTOMS OF ENDOMETRIOSIS
Insulin sensitivity may also play a role in endometriosis. A 2019 review30
looked at the likelihood of the coexistence of Type 1 diabetes and
endometriosis, including the prospect that therapeutic strategies could help
reduce complications. While Type 1 diabetes is an autoimmune disease,
endometriosis is not.
However, according to the paper, they share similar pathophysiological pathways,
including an association with chronic inflammation and an overactive immune
response. A 2002 study31 also showed women with endometriosis more frequently
had mechanical dysfunction in the gastrointestinal system and reactive
hypoglycemia with normal insulin levels.
According to the researchers, the nerve dysfunction found in women with
endometriosis was identical to that found in individuals with insulin resistance
and resulted in debilitating gastrointestinal symptoms. In addition to
strategies that improve insulin sensitivity and reduce resistance, women with
endometriosis may consider addressing other factors that contribute to symptoms
of endometriosis, such as:
• Avoiding endocrine disruptors — Endometriosis is hormone dependent, and data
has linked exposure to environmental endocrine disrupting chemicals (EDCs) with
the development of endometriosis. A 2023 study32 looked at epidemiological and
experimental data of four EDCs and found:
> "The available information strongly indicates that environmental exposure to
> EDCs such as PCBs, dioxins, BPA, and phthalates individually or collectively
> contribute to the pathophysiology of endometriosis."
One commonly used EDC is oxybenzone, found in many sunscreen formulations. The
Environmental Working Group (EWG) calls oxybenzone "the most worrisome sunscreen
active ingredient,"33 as the chemical is readily absorbed through the skin, is
associated with skin reactions and has demonstrated hormone-disrupting
properties.
A 2012 study34 associated benzophenone, the class of drugs to which oxybenzone
belongs,35 as an EDC that has a high likelihood of increasing the risk of
endometriosis. EDC chemicals are found in many everyday products, including
pesticides, plastics and food storage materials, and antibacterial soaps.36
• Avoiding sugar — Dysregulated blood sugar has a significant influence on
endometriosis as it promotes an inflammatory response in the body,37 which may
contribute to a flare-up of the disease and raise pain levels. As blood sugar
rises, cortisol can also rise which lowers progesterone levels and sets the
stage for higher levels of estrogen.38
• Considering physical activity — Physical activity and exercise is an important
factor in attaining and maintaining optimal health. Yet, for women with
endometriosis, they may want to consider physical activity a prescription to
help lower inflammation and painful symptoms. While the literature examining
endometriosis is not conclusive, data does reveal that physical activity helps
lower the inflammatory response.39
One review of the literature40 was unable to find enough quality studies to
produce a quantitative meta-analysis, but did identify a couple studies showing
activity improved pain intensity and decreased stress levels. The researchers
suggested future high-quality randomized controlled trials were necessary to
determine if physical activity improved symptoms and quality of life.
A 2023 study41 in the International Journal Gynecology and Obstetrics, reviewed
the benefits of physical therapy in women with endometriosis, doing a
meta-analysis on six studies that evaluated pain intensity and quality of life
measures. The data show these non-pharmacological therapies "are a therapeutic
option for women with endometriosis for improving pain intensity and physical
function."
• Considering supplements — Women with endometriosis may also consider
nutraceuticals that have demonstrated a beneficial effect against the pain and
symptoms of endometriosis. N-acetylcysteine (NAC), chasteberry and melatonin may
all offer some relief.
In a 2013 Italian study,42 women who took 600 mg of NAC three times a day for
three consecutive days per week, for three months, saw such significant
improvement that half of the treatment group were able to cancel their
surgeries. Eight of the 47 women in the intervention group had complete
remission. The researchers concluded that:43
> "Our results are better than those reported after hormonal treatments … NAC
> actually represents a simple effective treatment for endometriosis, without
> side effects, and a suitable approach for women desiring a pregnancy."
Chasteberry is known as "the woman’s herb," and has a long history of use in
female fertility and hormonal health. A leaf decoction has demonstrated a
reduction in symptoms of endometriosis within clinical practice and reduction in
endometrial cyst size.44 Chasteberry may also help reduce inflammation and
balance reproductive hormones.45
Chasteberry may help increase progesterone production, which affects the luteal
phase of the menstrual cycle, the time from ovulation until bleeding starts.
These issues are often linked to menstrual irregularities, including
endometriosis.
Melatonin has also shown some promise for pain control. In one study,46 10 mg
per day of melatonin helped decrease pain by 39.8% and dysmenorrhea by 38.01%.
* 0
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* 0
*
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*
+ Sources and References
* 1, 10, 12, 13 Science Translational Medicine, 2023;15(700)
* 2 Journal of Critical Care Medicine, 2017;3(4)
* 3 Centers for Disease Control and Prevention, November 15, 2022
* 4 Indian Heart Journal, 2021;73(3)
* 5 Current Gastroenterology Reports, 2020;22(11)
* 6 Frontiers in Pharmacology, 2022; 13
* 7 Clinics and Practice, 2017;7(4)
* 8 The Invisible Extinction
* 9, 11 Nature, June 14, 2023
* 14 Science Alert, June 15, 2023 Para 7, 9
* 15 The Journal of Critical Care Medicine, 2017; 3(4)
* 16 Johns Hopkins Medicine, Endometriosis
* 17 Cleveland Clinic, Endometriosis, How is endometriosis diagnosed?
* 18, 19 Reproductive Sciences, 2021; 28(8)
* 20 Science Alert, April 17, 2023
* 21 Yale Medicine, Endometriosis
* 22 Endometriosis.net, June 20, 2018 subhead 1, para 1
* 23, 24 Human Reproduction Update, 2015;21(4)
* 25 Endometriosis, Endometriosis and Co-morbidities
* 26 Journal of the Chinese Medical Association, 2016; 79 (11)
* 27 Nature Genetics, 2023;55
* 28 International Journal of Women’s Health, 2017; 9
* 29 Frontiers in Neuroendocrinology, 2022;65
* 30 Journal of endocrinology, 2019; 243(3)
* 31 Fertility and Sterility, 2002; 77 (Supplement 1)
* 32 Reproductive Toxicology, 2023;115
* 33 Environmental Working Group, The trouble with ingredients in sunscreens
* 34 Environmental Science & Technology, 2012;46(8)
* 35 Biomonitoring California, Benzophenone-3
* 36 Endocrine Society, January 24, 2022
* 37 Cleveland Clinic, January 28, 2022
* 38 Endometriosis.net, March 9, 2021
* 39 Nature Reviews Immunology, 2011;11
* 40 BMC Women's Health, 2021; 21(355)
* 41 International Journal Gynecology and Obstetrics, 2023; 162(1)
* 42, 43 Evidence-Based Complementary and Alternative Medicine, 2013 (240702)
* 44 Current Drug Delivery, 2019; 16(5) 40% DTP 7.7
* 45 Cleveland Clinic, November 22, 2022
* 46 Pain, 2013;154(6)
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