The Link Between Endometriosis, Gut Health and Depression

Joan Nugent
3 min readJan 8, 2021
Image Credit: Shutterstock/ SizeSquares

Endometriosis comes with a myriad of symptoms and can often be associated with digestive issues and depression.

Evidence from observational studies indicates that endometriosis and depression often occur simultaneously. Researchers from the Queensland University of Technology comprehensively evaluated the link between endometriosis and depression. The researchers found a “significant genetic overlap” between endometriosis and depression.

The results of their study found a shared genetic etiology for endometriosis and depression. Additional analyses found evidence of a causal association between endometriosis and depression and at least one abnormal condition of gastric mucosa. The study confirmed the comorbidity of endometriosis and depression, implicated links with gastric mucosa abnormalities in their causal pathways and revealed potential therapeutic targets for further investigation.

There is consistent evidence on the growing global burden of endometriosis and depression, their adverse impacts on patients’ quality of life and consequences for higher risks of morbidity, infertility (endometriosis) and mortality (depression), these two disorders remain underdiagnosed, often misdiagnosed and undertreated, globally.

The signifcant genetic overlap and correlation between the two disorders found in our study confirm their comorbidity and indicate that, at the least, a proportion of endometriosis and depression patients share similar genetic etiology. Supporting this position, the independent gene-based test reveals the presence of a highly signifcant gene-level genetic overlap between endometriosis and depression.

Gut Bacteria and Endometriosis

Many women that have endometriosis also have gut health problems like irritable bowel syndrome (IBS) and small intestine bacterial overgrowth (SIBO).

Endometriosis is a disease that involves a dysfunctional immune response and inflammation. There is evidence suggesting the microbiome may influence the immune response in endometriosis.

Endometriosis is associated with increased levels of certain types of bacteria such as Escherichia coli (E. Coli), which is bacteria known to produce a toxin called lipopolysaccharide (LPS), causing an inflammatory response. One theory is that these pro-inflammatory bacteria and LPS may have moved from the gut into the pelvic cavity, which in turn promotes the onset and progression of endometriosis lesions.

In addition, the gut microbiome can also alter estrogen metabolism. When our microbiome is imbalanced (dysbiosis), it can cause an increase in the amount of free circulating estrogen; as endometriosis is an estrogen dependent condition, this is not an ideal situation.

Making Improvements to Your Gut Health

Some ways in which you can support your gut health and microbiome include:

  • Consume plenty of fiber from whole foods, such as vegetables, fruit, whole grains, nuts, seeds, and legumes. Eat at least 5 servings of fruit and vegetables per day.
  • Drink plenty of water (around 2.5 liters per day)
  • Address food intolerances as these contribute to inflammation and abdominal pain. If you are struggling with digestive health, see a nutritionist.
  • Try avoiding alcohol, sugar, trans fats, and processed foods.
  • Manage your stress levels; try belly breathing, yoga or spending time in nature.

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Joan Nugent

Northern Ireland born, Manchester-based Editorial Production Coordinator. Main interests include NI LGBTQIA+ Issues and Endometriosis.