The Gut Microbiome in Endometriosis: What the Research Shows

Your gut is home to trillions of micro-organisms - bacteria, fungi, viruses - that collectively form the gut microbiome. In recent years, researchers have identified a consistent pattern: women with endometriosis show distinctly different gut microbiome profiles compared to those without the condition.

A landmark 2024 cohort study of 1,000 individuals by Pérez-Prieto et al., published in BMC Medicine, confirmed distinct gut microbiome signatures in endometriosis patients. A 2025 analysis by Wang et al. found that the ratio of Firmicutes to Bacteroidetes — two major bacterial phyla — is elevated in endometriosis patients, indicating a state of gut dysbiosis (imbalance). Earlier work by Huang et al. (2021) identified specific bacterial genera, including Ruminococcus, as having high diagnostic value as potential biomarkers for the condition.

A 2025 review in Frontiers in Cellular and Infection

Microbiology found that abnormal Fusobacterium and Gram-negative bacteria influence the immune microenvironment of ectopic lesions through lipopolysaccharides (LPS), contributing to chronic inflammation and disease progression.

The Estrobolome: Your Gut's Role in Oestrogen Regulation

Endometriosis is an oestrogen-dependent condition — it grows and thrives in the presence of oestrogen. What many people do not realise is that a subset of gut bacteria, known collectively as the estrobolome, plays a central role in regulating how oestrogen is metabolised and either excreted or recirculated in the body.

When the gut microbiome is disrupted, the estrobolome is disrupted with it. This can lead to elevated circulating oestrogen levels - precisely the hormonal environment that fuels endometriotic lesion growth. Supporting the health and diversity of the gut microbiome is therefore not simply a digestive concern; it is directly relevant to the hormonal drivers of endometriosis itself.

Here are three health shot recipes for your suggested immune support, gut health recovery, and an energy boost. Each recipe features a blend of classic and slightly offbeat ingredients, specifically with blood sugar balance and post-indulgence support in mind.

The recipes reflect current evidence-based nutrition trends.

Each recipe makes approx. 10 shots that should be stored in airtight glass containers in the fridge and used within 3-5 days for optimal potency, flavour, and nutritional value. If you'd like to extend their shelf life, you can freeze individual portions in ice cube trays for up to 2-3 months. Shaking or stirring before serving helps re-mix any settled ingredients for maximum benefit.

Immune Boost Shot

This shot is great for flu season, using traditional immunity boosters like ginger, turmeric, and citrus. It also includes apple cider vinegar, a blood sugar modulator. The pepper activates the anti-inflammatory properties of the turmeric.

• 3 oranges, juiced or 200ml juice (not from concentrate)

• 3 lemons, juiced

• 3 tablespoons apple cider vinegar (with “the Mother”)

• 3 inches of fresh ginger, grated or juiced

• 2 tsp turmeric powder

• ½ tsp of cayenne pepper

• 1 tablespoon honey (preferably raw)

• ½ tsp of black pepper

Mix the honey, turmeric, and a tablespoon of hot water until smooth. Add all other ingredients and shake well. Cool and fridge.

 Have a shot in the morning after a late night or as a daily seasonal boost.

Gut Health Weekend Recovery Shot

This quirky “recovery” shot targets gut balance post-indulgence and includes ingredients that support microbial and enzymatic activity, plus a touch of matcha for energy and clarity benefits.

• 200ml beetroot juice (not from concentrate)

• 200ml pineapple juice (fresh or frozen)

• 2 kiwis juiced

• 2 teaspoons matcha powder

• 3 tablespoons of ginger juice

• 2 squeezed lemon

• 4 teaspoons of apple cider vinegar

• Dash of sea or Himalayan rock salt

Blend all ingredients thoroughly, then strain if needed.

Energy Boost Shot

A pick-me-up, this shot offers both immediate and sustained vitality, using spinach for iron, cucumber for hydration, and citrus and apple to help modulate blood sugar.

• 200ml apple juice (not from concentrate)

• 1/4 cucumber juiced.

• 2 limes, juiced.

• 2 large handfuls of spinach leaves

• 2 thumb-sized pieces of fresh ginger, juiced.

• Pinch of Himalayan rock salt (for minerals and to support electrolyte balance)

• 1 cup cold water

Blend all ingredients until smooth, strain, and serve as a shot. The inclusion of leafy greens, low-GI fruits, and electrolytes makes this shot energising and blood-sugar-friendly—excellent for a midday boost or pre-workout.

Her main symptoms were bloating, intermittent diarrhoea, fatigue, and brain fog that severely impacted her quality of life – she went out less often as she never knew when she would need to be near a toilet. After our initial consultation and diet analysis we agreed that to get to the root cause, we would try and eliminate anything specific that might be triggering an inflammatory reaction. There are a few common foods that we could have started with but she was at her wits end and was happy to pay for a comprehensive gut inflammation test was the quickest approach and could be performed easily at home. This test measures her reaction to 176 foods in the following categories:

In recent years, the field of nutrition has expanded beyond simply focusing on individual food choices towards a broader understanding of how the environment, particularly soil health, affects the quality of food and, in turn, human health. Regenerative nutrition is an emerging concept linking the practice of regenerative agriculture with the nutrient density of foods and long-term wellness. This article explores the definitions of regenerative nutrition, why soil health matters for nutrient quality, how to avoid greenwashing claims in sustainable food purchases, practical shopping and cooking tips, and ways to improve soil health when growing your own food.

Client Case Study

Every client is treated as an individual and assessed on that basis, this clients personalised recommendations were specifically for her.

A 32-year-old female with a fresh diagnosis of PCOS presented came to see me last year. She had a history of being overweight (BMI 31), irregular menstrual cycles, and had difficulty conceiving for over the prior year. A diet analysis showed above average consumption of ultra-processed foods (UPFs) like white bread, crisps, biscuits, packet snacks, and takeaways, very little fibre and low omega-3. Twinned with this she had limited physical activity and used the car to get around. Her goals when we first met were weight loss, menstrual regularity, and improving her chances of fertility.

Dietary and Lifestyle Recommendations

Recommendation 1

Replaced high-GI foods (white rice, pastries) with low-GI alternatives:

Whole grains, brown rice, barley, and quinoa.

Non-starchy vegetables, lots of leafy greens, broccoli, and peppers.

Incorporated chromium sources like broccoli, barley, lentils, and apples.

Fruits to include berries and apples for fibre and slower sugar absorption.

Low-GI diets improve insulin sensitivity and reduce blood sugar spikes. Low GI supports weight loss, critical for managing PCOS-related insulin resistance.

Supplement Recommendation

Vitamin D

Daily supplement (2000 IU) to address deficiency. Vitamin D deficiency is common in PCOS; supplementation improves menstrual regularity and ovulation.

Magnesium

400 mg/day of magnesium glycinate. This reduces insulin resistance, lowers testosterone, and alleviates anxiety/sleep issues.

Lifestyle Adjustments

Physical Activity

Daily 30-minute walks to boost insulin sensitivity and aid weight loss.

UPF Reduction

Minimised processed snacks, opting for whole-food snacks like nuts and fruit with nut butter.

Outcomes

Weight Loss

Lost 12% body weight over 6 months (BMI reduced to 27).

Menstrual Cycle

Regular cycles resumed within 4 months.

Fertility

Conceived naturally after 9 months of dietary/lifestyle changes.

Symptom Improvement

Reduced acne, improved energy, and fewer sugar cravings.

Key Takeaways

This case highlights the effectiveness of combining low-GI nutrition, targeted micronutrient support (chromium, vitamin D, magnesium), and moderate exercise in managing PCOS. The client’s success stemmed from a structured yet flexible plan focusing on sustainable swaps (e.g., whole grains over refined carbs) and addressing insulin resistance holistically.

Need guidance tailoring a PCOS-friendly diet to your needs?

What to Expect:

- Personalised Care: Choose between a nutritional therapy session or a lymphatic massage tailored to your needs.

- Educational Workshops: Learn about the science behind anti-inflammatory practices during our nutrition workshop.

- Movement & Relaxation: Enjoy yoga sessions focused on mobility and breathwork for inflammation reduction.

- Healing Foods: Savour an anti-inflammatory lunch featuring nutrient-dense ingredients that align with wellness goals.

- Mindfulness Activities: Engage in meditation sessions to support mental clarity and stress reduction.