Can the vaginal microbiota be used as a tool for predicting the severity of endometriosis?

According to the results of a recently published study, analyzing the vaginal flora may make it possible to determine the severity of endometriosis, a very painful gynecological disease.

 

Endometriosis is a chronic gynecological disease which happens when tissue similar to the lining of the uterus grows outside the uterus (womb). This abnormal migration results in inflammation and intense pain. The exact causes of endometriosis remain unknown, but genetic, hormonal, environmental and immune system factors seem to be involved. Currently, the disease can only be diagnosed through surgery. That is why, a team has attempted to develop a non-invasive diagnostic test able to characterize vaginal and intestinal flora of women suffering from endometriosis.

Vaginal microbiota: a predictive tool

To this end, vaginal secretions and rectal samples were taken from 35 patients with endometriosis and 24 control subjects aged between 21 and 49 years, at two different time points: during menstruation and outside this period. The results showed no difference in the composition of the gut and vaginal microbiota of the two groups, regardless of the phase of menstrual cycle. However, differences in the vaginal microbiota were observed within the group of women with endometriosis. During menstruation, the bacterial genus Anaerococcus was found in abundance in women with severe forms of the disease when compared to women with less advanced forms, which suggests that Anaerococcus may predict the severity of endometriosis.

Further research

The team’s findings may prove especially useful for future research on the role of the vaginal microbiota, and more specifically for the diagnosis of advanced stages of endometriosis, although these results require confirmation on larger cohorts. All in all, these preliminary results open up new research avenues that will allow a better understanding of the causes of endometriosis and help in the development of new non-invasive diagnostic tools for the disease.

 

Sources:

Perrotta AR, Borrelli GM, Martins CO, et al. The Vaginal Microbiome as a Tool to Predict rASRM Stage of Disease in Endometriosis: a Pilot Study. Reprod Sci. 2020;27(4):1064–1073. doi:10.1007/s43032-019-00113-5