Nov 14, 2024 By Kristin Emery 4 min read

Could an extremely painful and hard to diagnose condition that affects nearly 10% of American women really be cured with something as simple as dietary supplements?

That’s a possibility raised by results of a new study on the causes of endometriosis, a condition that occurs when tissue that normally lines the inside of the uterus (called the endometrium) grows outside of the uterus.

“This tissue can grow on the ovaries, fallopian tubes, and other organs in the pelvic cavity,” explains Dr. Rachel Cullifer, an ob-gyn with Allegheny Health Network’s Women’s Institute specializing in minimally invasive gynecologic surgery, pelvic pain and endometriosis. “In severe cases, it can also grow on other areas of the body.”

Although endometriosis affects nearly 200 million women around the world, the National Institutes of Health say only about a third of them go on to seek professional medical care for it.

Endometriosis causes pain and discomfort because the endometrial tissue outside of the uterus continues to grow and shed each month, just like the tissue inside the uterus.

“This can cause inflammation, scarring, and pain,” says Cullifer. “The pain associated with endometriosis can be severe and debilitating, and it can affect a woman’s quality of life.”

Signs and symptoms of endometriosis include significant pain, especially extremely painful menstrual cramps, pain during intercourse, painful bowel movements, bleeding or spotting between periods, infertility and digestive problems.

But what causes this painful condition? That question has perplexed the medical community for decades. Now, a new discovery may lead to an early test for the disease and possibly new, less invasive treatments.

A new study by researchers at Baylor College of Medicine shows a specific set of bacteria in a woman’s gut microbiome may be the key. Doctors there found that a lack of a bacterial byproduct called 4-hydroxyindole is linked to an increased risk of endometriosis. It’s a compound produced by what’s considered “good bacteria.” But women with endometriosis were found to have less of this “good bacteria” in their system as compared to women without the disease.

“There are some preliminary studies showing a link between the gut microbiome and its ability to promote or protect against endometriosis,” Cullifer says. “We think the link has to do with proinflammatory bacteria. While studies show promise, there is not yet a specific treatment targeting this in endometriosis. With this being said, other inflammatory disease processes have seen improvement by avoiding inflammatory foods and this could be safely tried.”

The Baylor results indicate that stool tests might help predict a woman’s risk of endometriosis and that treatment for the condition may start with dietary supplements that would alter the patient’s microbiome. Could it be as simple as giving endometriosis sufferers 4-hydroxyindole? Studies treating lab mice with the bacteria prevented endometriosis or stunted progression of inflammation and pain associated with it. That could lead to a stool test that could easily diagnose what now often takes doctors years to figure out. Doctors often incorrectly diagnose women with bowel conditions rather than the tissue disorder. Treating endometriosis with dietary supplements or less invasive ways of altering the gut microbiome would be a huge improvement in patient care.

“The current treatment for endometriosis is surgical via excision of lesions or by hysterectomy or medical with hormonal suppression of lesions,” Cullife said. “I think the hope of the studies regarding the gut microbiome is that we might be able to add dietary changes or antibiotics to alter the gut microbiome in an effort to slow the progression of endometriosis.”

The Baylor study researchers also said their findings may lead to help for those with inflammatory bowel disease since their data showed a link between the role the microbiome plays in that condition along with endometriosis.