Did you know that your gut bacteria influences your hormones and the way you process estrogen? And that a negative shift in your gut microbiota can contribute to the recirculation of estrogen, ultimately factoring into conditions like PMS and even endometriosis. Today we’re going to dive into why healthy gut bacteria (and the diversity of that bacteria) matters, and the portion of your microbiome known as the ‘estrobolome.’


A potential contributor when it comes to endometriosis is gut inflammation and altered gut microbiota (referred to as dysbiosis, an overgrowth of pathogenic bacteria and a disruption or lack of richness and diversity when it comes to healthy, beneficial bacteria). 

Altered gut microbiota and the often-resulting increased intestinal permeability can lead to systemic inflammation and immune dysregulation (seen in autoimmune disease), not to mention hormone dysregulation. 

Research shows that a disrupted microbiome is involved in the onset and continuing progression of endometriosis. Women with endometriosis have higher amounts of dysbiosis overall as well as bacterial overgrowth in the gut microbiome.

An imbalanced gut microbiome and increased intestinal permeability (leaky gut) may result in the migration of harmful substances into the bloodstream, triggering an immune response and promoting immune-mediated inflammation, including the increased inflammatory cytokine levels and abnormal cell-mediated pathways seen in endometriosis (3). Endometriosis is considered to be related to autoimmune disorders because its characteristics are similar to those of autoimmune diseases, including the cytokine abnormalities mentioned above.

Further, research has found that the diversity of the gut microbiota in patients with endometriosis is significantly decreased, whereas the ratio of Firmicutes/Bacteroidetes is increased – an unhealthy shift away from optimal microbiome balance. Because gut bacteria diversity and richness is such an important overall indicator of health and longevity, the decrease in gut diversity seen in those suffering from endometriosis is a clue and point of concern. (4) Another clue is that women with endometriosis also have much higher rates of IBS, suggesting an important connection between endometriosis and a disrupted microbiome.

Lastly, the gut dysbiosis observed in endometriosis directly relates to the estrogen dominance piece, as bacterial overgrowths can actually recirculate estrogen within the gut, promoting cell proliferation in estrogen-sensitive tissues such as the breasts, endometrium, cervix, and ovaries.

This is because unwanted microbes within the segment of the microbiome that influences the metabolism of estrogen (called the estrobolome) produce something called beta-glucuronidase. This enzyme, made by bacteria in high amounts when out of balance, alters estrogens into more active forms, which have a stronger affinity for estrogen receptors. 

The more beta-glucuronidase that the microbes in your gut produce, the less estrogen is excreted out of the body (which ultimately gets recirculated, binds to receptors, and contributes to tissue proliferation).

Thus, addressing gut health and restoring balance within the microbiota through a balanced diet, prebiotics, probiotics, and targeted protocols to treat potential gut infections like SIBO may be an important step in managing endometriosis symptoms.


Foods rich in fiber, such as legumes (beans), flaxseeds and chia seeds, all aid in eliminating excess hormones from the body through the stool. When enough fiber is present in the gut, toxins and estrogen released through bile have something to latch onto and can be safely excreted, reducing excessive estrogen levels. Including these fiber sources in your diet is one of the easiest and quickest things you can do to reduce estrogen dominance. These fiber-rich foods also increase gut microbiota diversity and feed healthier gut bacteria over time. One of our favorite ways to sneak a solid dose of fiber into meals or as a snack is Olivia’s High-Fiber Chia Pudding linked here.

Additional helpful dietary strategies include:

  • Eating more fermented foods such as sauerkraut and kimchi to help rebalance the gut microbiota and increase bacterial diversity.
  • In addition to eating your probiotics, take a probiotic that contains Lactobacillus strains. Lactobacillus acidophilus, for example, can help crowd out the bacteria that produce beta-glucuronidase and ultimately reduce estrogen recirculation. Our probiotic formula is rich in Lactobacillus strains, as well as enzymes and prebiotic fiber that promote a healthier gut environment.
  • Consume prebiotic foods such as asparagus and plantains (green bananas) that are rich in fructo-oligosaccharides or inulin. These foods feed your good bacteria, increase your gut diversity, and again – help crowd out the ‘bad guys.’
  • Bump up the cruciferous veggies such as broccoli, cauliflower, cabbage, and kale. The liver’s phase II detoxification pathway called the ‘sulfation’ pathway requires sulfur-rich foods in order to function properly and metabolize various toxins and hormones. And of course, these foods are also rich in fiber for our beneficial gut bacteria.


As mentioned, emerging research suggests that a disrupted microbiome is involved in the onset and continuing progression of endometriosis. Women with endometriosis have higher amounts of dysbiosis overall as well as bacterial overgrowth in the gut microbiome. And it makes sense – the portion of our gut microbiome called the ‘estrobolome’ influences hormones, specifically estrogen, contributing to the altered metabolism and recirculation of estrogen if dysbiosis is present. Focus on maintaining a healthy estrobolome by consuming probiotic-rich, fiber-rich, and antioxidant-rich foods. Berries specifically help promote healthy bacteria and discourage the growth of bad bacteria in the gut. You could eat a handful of berries, or add whole ground berry powder to your smoothies to get a daily dose.

Avoid food triggers that result in gut inflammation for you (dairy is a common one, so pay attention to your body’s cues). You can also follow the tips within this blog post to increase your gut bacteria diversity and restore balance to your microbiome, as well as explore our gut-supporting formulas here. Working with a practitioner who can perform a functional “GI map” in order to test you for SIBO and other intestinal overgrowths is key if any digestive symptoms are present, so that they may create a comprehensive gut-balancing program that’s tailored to you involving either botanicals, antibiotics, or both.

Recipes to increase variety in your diet + microbiome

  1. Nick’s Parsnip Mash – instead of potatoes, rotate in this resistant starch star to feed the good bugs that produce immune modulating short chain fatty acids!
  2. Nick’s Okra Chips – an intimidating veggie turned into a delicious, crunchy snack.
  3. Nick’s Simply Seasoned Garlic Artichoke – not only is snacking on this beautifully, simply seasoned artichoke going to promote the growth of your good bacteria by providing a unique prebiotic fiber we don’t always eat regularly… artichokes are famous for supporting our liver’s detoxification functions and pathways.
  4. Nick’s Meticulous Cabbage Salad – so many of you tell us that you make this at least once a week, and it can always be modified to include even more veggies depending on what you have in the fridge!

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