The link between endometriosis and an infectious bacterium

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Last Updated19/07/2023

A study has found a correlation between the presence of Fusobacterium and endometriosis.
It opened the door for researchers to potentially develop non-invasive tests for the condition as well as treat its severity with antibiotics.
Endometriosis currently affects one in 10 women worldwide.

Endometriosis: A reproductive disease affecting one in 10 women worldwide, involves the growth of lesions on pelvic organs such as the ovaries.
These lesions are composed of endometrium, a layer of tissue lining the uterus.
It causes infertility, chronic pain during periods, pelvic pain, bloating, nausea and fatigue and is also associated with depression and anxiety.

A new study points to a link between a bacterium associated with infections in the oral cavity, and endometriosis.
The experiment was conducted with a cohort of 155 women in Japan, of which 79 were diagnosed with endometriosis while 76 were healthy.
To assess the direct effect of the bacteria on the disease, the scientists transplanted endometrial tissue inside the abdominal cavity of two sets of mice, one infected with Fusobacterium and another without it.
They found that the bacteria triggered the growth of larger lesions of endometriosis in the former set, relative to the latter.
The study concluded that the bacteria had a role in the formation and aggravation of endometrial lesions.

Scientists worldwide have come up with different ideas of the disease’s cause.
One is retrograde menstruation – when some part of the menstrual blood flows backwards, into the abdominal region, instead of flowing out of the vagina.
Another possibility: The inability of the immune system to detect and eliminate blood cells from retrograde menstruation, allowing it to persist in the pelvic region, points to some dysfunction in the immune system.
Researchers have also linked endocrine-disrupting substances to the endometriosis as they interfere with the signalling, production, transport and metabolism of hormones such as oestrogen and progesterone, which are causal factors of endometriosis.
The condition has also been linked to genetic and metabolic factors.
But for all their efforts, scientists are yet to identify the root cause of endometriosis.
So treatment options are limited to hormone therapies, contraceptive pills and laparoscopic surgery to remove the lesions.

Endometriosis currently takes six years on average to be diagnosed. And even after a diagnosis, few treatment options are available.
A common response to bacterial infections is antibiotics; the new study considered it as well – and in doing so, opened up potentially new ways to diagnose and treat endometriosis.
For example, a 2019 study investigating the relationship between gut dysbiosis and endometriosis found that treating mice with metronidazole, an antibiotic that targets certain microbes, instead of broad-spectrum antibiotics slowed the rate at which the condition progressed.
Researchers found that fibrous food can help manage the condition because, while metabolites released by certain microbes can aggravate endometrial lesions, other metabolites produced by the fermentation of certain types of food can protect from the condition.
This is because the latter can decrease the abundance of Fusobacterium and other infectious bacterial species.
This is why the consumption of food with high amounts of antioxidants, probiotic foods (with Lactobacillus gasseri bacteria), and food rich in omega-3 fatty acids have also been found to help suppress the development of endometriosis.

In elucidating an inherent connection between gut health and endometriosis, the studies also pave the way for a future in which researchers can devise personalised treatment options.