Your gut isn’t just a tube for digesting food. It’s home to trillions of bacteria that:
• Help break down food
• Make key nutrients (like B vitamins)
• Train your immune system
• And — importantly — regulate estrogen levels
This bacterial community is called the gut microbiome, and when it’s healthy and diverse, it supports balanced hormones. But when the microbiome is out of balance — a condition called dysbiosis — problems can arise.
Inside the gut, a specific group of bacteria known as the estrobolome helps process estrogen. These bacteria produce enzymes (like beta-glucuronidase) that influence how much estrogen is reabsorbed into the bloodstream versus excreted.
When the estrobolome is overactive or underactive, it can lead to:
• Excess circulating estrogen → linked to endometriosis, fibroids, PMS, and breast tendernes
• Too little estrogen → contributing to mood changes, bone loss, and vaginal dryness
So a disrupted gut can directly amplify hormonal imbalances.
Both gut dysbiosis and endometriosis are associated with chronic inflammation. When the gut barrier is weakened (a condition sometimes called “leaky gut”), it allows inflammatory molecules to pass into the bloodstream. This triggers an immune response — and in people with endometriosis or PCOS, it can worsen pelvic pain, fatigue, and hormonal chaos.
While this field is still developing, early studies have found:
• Women with endometriosis often have altered gut microbiomes compared to those without the condition. [Study: Ata et al., 2019, Scientific Reports]
• A high-fiber, plant-rich diet may help support a more balanced gut flora and improve estrogen metabolism. [Study: Fuhrman et al., 2004, Journal of Nutrition]
• Some researchers are exploring probiotic therapy as a future tool for managing hormone-related conditions.
You can’t fully control your hormones — but you can support your gut.
Here are some gut-friendly, hormone-supporting habits:
• Eat more fiber: vegetables, fruits, legumes, and seeds
• Avoid excessive sugar and processed foods
• Include fermented foods: yogurt, kefir, sauerkraut, kimchi
• Consider a probiotic — talk to your provider first
• Manage stress — cortisol (the stress hormone) also affects gut balance
• Support liver detoxification (which works with your gut to clear estrogen): eat cruciferous vegetables like broccoli and cauliflower
The gut isn’t just about digestion — it’s a key player in how your body handles hormones, pain, and inflammation.
If you’re struggling with endometriosis, PCOS, or unexplained hormone symptoms, supporting your gut might be an empowering place to start.
Here are some helpful articles and research:
• The Gut Microbiome and Estrogen Metabolism – NIH
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6471213/
• Gut Microbiota and Endometriosis – Scientific Reports
https://www.nature.com/articles/s41598-019-39645-2
• How the Gut Influences Hormones – Integrative Medicine Journal
Your gut isn’t just a tube for digesting food. It’s home to trillions of bacteria that:
• Help break down food
• Make key nutrients (like B vitamins)
• Train your immune system
• And — importantly — regulate estrogen levels
This bacterial community is called the gut microbiome, and when it’s healthy and diverse, it supports balanced hormones. But when the microbiome is out of balance — a condition called dysbiosis — problems can arise.
Inside the gut, a specific group of bacteria known as the estrobolome helps process estrogen. These bacteria produce enzymes (like beta-glucuronidase) that influence how much estrogen is reabsorbed into the bloodstream versus excreted.
When the estrobolome is overactive or underactive, it can lead to:
• Excess circulating estrogen → linked to endometriosis, fibroids, PMS, and breast tendernes
• Too little estrogen → contributing to mood changes, bone loss, and vaginal dryness
So a disrupted gut can directly amplify hormonal imbalances.
Both gut dysbiosis and endometriosis are associated with chronic inflammation. When the gut barrier is weakened (a condition sometimes called “leaky gut”), it allows inflammatory molecules to pass into the bloodstream. This triggers an immune response — and in people with endometriosis or PCOS, it can worsen pelvic pain, fatigue, and hormonal chaos.
While this field is still developing, early studies have found:
• Women with endometriosis often have altered gut microbiomes compared to those without the condition. [Study: Ata et al., 2019, Scientific Reports]
• A high-fiber, plant-rich diet may help support a more balanced gut flora and improve estrogen metabolism. [Study: Fuhrman et al., 2004, Journal of Nutrition]
• Some researchers are exploring probiotic therapy as a future tool for managing hormone-related conditions.
You can’t fully control your hormones — but you can support your gut.
Here are some gut-friendly, hormone-supporting habits:
• Eat more fiber: vegetables, fruits, legumes, and seeds
• Avoid excessive sugar and processed foods
• Include fermented foods: yogurt, kefir, sauerkraut, kimchi
• Consider a probiotic — talk to your provider first
• Manage stress — cortisol (the stress hormone) also affects gut balance
• Support liver detoxification (which works with your gut to clear estrogen): eat cruciferous vegetables like broccoli and cauliflower
The gut isn’t just about digestion — it’s a key player in how your body handles hormones, pain, and inflammation.
If you’re struggling with endometriosis, PCOS, or unexplained hormone symptoms, supporting your gut might be an empowering place to start.
Here are some helpful articles and research:
• The Gut Microbiome and Estrogen Metabolism – NIH
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6471213/
• Gut Microbiota and Endometriosis – Scientific Reports
https://www.nature.com/articles/s41598-019-39645-2
• How the Gut Influences Hormones – Integrative Medicine Journal
Your support can transform lives. Every donation helps us fund research, advocate for better care, and provide essential grants to women facing debilitating conditions.
Your support can transform lives. Every donation helps us fund research, advocate for better care, and provide essential grants to women facing debilitating conditions.
The Immune Connection: Are Endometriosis, Adenomyosis, and PCOS Autoimmune Conditions?
By Our Daughters Foundation
More and more women are asking an important question: Could my hormone-related illness also be connected to my immune system?
Conditions like endometriosis, adenomyosis, and polycystic ovary syndrome (PCOS) are often discussed in the context of reproductive health or hormonal imbalance. But researchers are beginning to explore deeper connections—specifically, whether autoimmunity plays a role in these diseases.
Let’s break down what the science says—and what questions remain unanswered.
What Is Autoimmunity?
The immune system is designed to protect the body from threats like viruses and bacteria. But in autoimmune diseases, the immune system becomes misguided and starts attacking the body’s own cells and tissues.
Common autoimmune conditions include:
• Lupus
• Rheumatoid arthritis
• Hashimoto’s thyroiditis
• Multiple sclerosis
Symptoms vary widely, but many autoimmune conditions involve chronic inflammation, pain, fatigue, and a pattern of flare-ups.
The Immune System and Endometriosis
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus—causing pain, inflammation, and sometimes infertility. While its exact cause is still debated, many researchers believe that the immune system fails to clear out these rogue cells effectively.
Several studies have found:
• Women with endometriosis often have higher levels of inflammatory markers, like cytokines and prostaglandins.
• Natural killer (NK) cell activity is lower in women with endometriosis, impairing the immune system’s ability to destroy misplaced cells.
• There are elevated autoantibodies in some patients, suggesting an autoimmune component.
Some scientists now consider endometriosis to be a non-classical autoimmune disease—showing many features of one without meeting all diagnostic criteria.
Further reading:
• NIH - Immune dysfunction in endometriosis: https://pubmed.ncbi.nlm.nih.gov/30664929/
• Cleveland Clinic - Endometriosis and the Immune System: https://health.clevelandclinic.org/endometriosis-and-the-immune-system/
What About Adenomyosis?
Adenomyosis is sometimes called the "sister disease" of endometriosis. It occurs when endometrial tissue grows into the muscular wall of the uterus. It's less studied, but immune abnormalities have also been observed.
Research is still emerging, but here’s what we know:
• Women with adenomyosis show immune cell changes and chronic inflammation within the uterus.
• Some studies report increased macrophage and mast cell activity—cells involved in both immune defense and inflammation
• The condition often coexists with endometriosis, raising questions about shared immune pathways.
While it’s too early to label adenomyosis an autoimmune disorder, it may involve an immune imbalance that contributes to symptoms.
Further reading:
• Frontiers in Immunology - Immunopathogenesis of Adenomyosis: https://www.frontiersin.org/articles/10.3389/fimmu.2021.796273/full
PCOS and Autoimmune Overlap
Polycystic ovary syndrome (PCOS) is primarily known as a hormonal disorder involving androgen excess and insulin resistance. However, there’s growing interest in its immune connections, especially in women with chronic inflammation or thyroid issues.
Emerging links include:
• Hashimoto’s thyroiditis (an autoimmune thyroid disorder) is more common in women with PCOS.
• Inflammatory markers like C-reactive protein (CRP) are often elevated in PCOS patients.
• Some PCOS patients have anti-ovarian antibodies, suggesting potential autoimmunity.
Still, the autoimmune theory is more speculative in PCOS than in endometriosis.
Further reading:
• Journal of Clinical Endocrinology & Metabolism - PCOS and Autoimmune Disease: https://academic.oup.com/jcem/article/106/9/e3536/6280755
Why Does This Matter?
If immune dysfunction is part of the puzzle, treatment strategies may need to shift. Many women with endometriosis, adenomyosis, or PCOS are treated solely with hormone suppression—but if autoimmunity is involved, we may also need to address inflammation, gut health, and immune regulation.
There’s also hope that newer treatments—like immunomodulatory therapies or even personalized nutrition and lifestyle interventions—could improve outcomes when tailored to the immune system’s role.
Bottom Line
We don’t yet have all the answers, but the research is evolving. Endometriosis, adenomyosis, and PCOS may not be traditional autoimmune diseases—but they often coexist with immune dysfunction, and the overlap deserves attention. At Our Daughters Foundation, we believe in honoring women’s voices, advocating for deeper research, and pursuing whole-body solutions.
If you’ve experienced overlapping conditions like endo, thyroid disease, or unexplained inflammation—you’re not alone.