Probiotics, Pain and Endometriosis: What 1 Study You Should Know

probiotics, pain, endometriosis
probiotics and endometriosis

Disclaimer: This is not intended to be medical advice, or to diagnose or treat any medical condition. Please consult a qualified medical professional for those instances.

Probiotics are not a new phenomenon but dysbiosis is on the rise. Our ancestors have been fermenting vegetables, making cheese and using other raw dairy cultures for centuries, if not longer, which produced nourishing bacteria for the body. What became a more recent occurrence, the loss of probiotics from the diet and the introduction of dead food (foods void of live culture), has contributed to Americans’ weak digestive health. Fortunately, many now make it a priority to utilize probiotics and ferments as a part of their daily routine.

Here at A Pain in the Endo, we try to make all of our connections relevant for treating endometriosis holistically. And there are good reasons why you should include probiotics in your diet if you suffer from endometriosis. For one, it’s an important health practice in general, but recent research studies have found a link between the consumption of probiotics and the reduction in pain from endometriosis.

The Role of Probiotics

Our ancestors knew the importance of eating food that was alive, or, food that contained good bacteria. The processes that helped to preserve food also created beneficial bacteria which also helped the immune system.

With the advent of marketed convenient processed foods and the high use of antibiotics among other reasons, our guts have responded with aches and pains from leaky gut syndrome, bloating, SIBO, IBS and many other modern physical problems. The good bacteria have literally been killed off, along with our vitality, immunity and good health. Including probiotics in your diet helps to rebuild your colony of good gut bacteria, immunity and vitality. I made mention of the importance of using probiotics in my post here about good digestive health habits, which covers the topic of digestive health more broadly.

Furthermore, having a good gut colony can also influence your mood, thoughts and brain according to a recent study. It was found that many chemical neurotransmitters responsible for feeling good are actually housed in the gut. “Scientists have found that gut bacteria produce many other neurotransmitters such as dopamine, norepinephrine, acetylcholine, and GABA, which are critical for mood, anxiety, concentration, reward and motivation” (source)

These reasons may compel just about anyone to consume probiotics on a daily basis. They are equally important for those who suffer from endometriosis.

probiotics and endometriosis

Gut Microbiota Health and Endometriosis

There have been several recent studies on the inclusion of healthy bacteria in the gut and the treatment of endometriosis.

A 2010 randomized, double-blind, placebo-controlled study found that lactobacillus gasseri is very effective on the menstrual pain and dysmenorrhea in endometriosis patients. (1) In the study, a group of 62 women were given either 100mg of lactobacillus gasseri or a placebo for 12 weeks, and a statistically significant number of women reported less pain without any adverse side effects after taking the probiotic strain.

This study provides an alternative natural remedy to NSAIDs which have become the standard go-to for many women experiencing pain from this condition, which is important because NSAIDs have been found to cause ulcers and to increase prostaglandins from arachidonic acid, which is suspected to cause endometrial pain. The presence of arachidonic acid in red meat is one reason why you also many want to avoid red meat when trying to heal endo symptoms.

Another study published in 2019 found that the bacteria strain Lactobacilus rhamnosus helped to reduce certain harmful bacteria strains in the female reproductive tract, as well as normalize the Ph level and show no signs of cell toxicity or irritations. The bacteria was found to also help women in pregnancy and infant cycles.

This study builds on research on the same strain of Lactobacilus rhamnosus from 2016 and 2018 respectively. The 2016 study found that women with higher levels of the strain had higher pregnancy and live birth outcomes, while those with lower levels were more likely to miscarry or remain infertile. The 2018 study also links low-Lactobacillus endometrial microbiota and infertility source.

And, most recently, a March 2022 study indicates that probiotics may be used along with other supplements as a treatment for endometriosis. Folks, this is important. The medical community has come a long way over the years, and finally a research study indicates what you already know intuitively and through study: endometriosis requires an multi-layered approach to healing.

Gut and Reproductive Tract Feeders

probiotics, including sauerkraut, kvass, rye bread
Photo by Polina Tankilevitch on

So what are some fantastic ways to get probiotics into your system? Aside from a quality probiotic supplement, you can easily make your own fermented foods which naturally contain many strains of good for your gut bacteria, including the Lactobacillus strain.

Making your own tends to be less expensive and more timely than store bought versions.

My favorite way to get good bacteria is by fermenting foods at home, particularly sauerkraut. Though you can use a wide array of vegetables for this diy process, including carrots, daikon, cucumbers, cauliflower and others, cabbage provides immune enhancing properties and is my favorite fermented staple.

Many cultures have their special fermented food items. Others include kvass, kimchi, miso, and kefir milk or kefir water.

Favorite Ferments

  • Sauerkraut
  • Kimchi
  • Kvass
  • Water Kefir
  • Milk Kefir
  • Buttermilk
  • Miso


Histimine Reactions

While many research studies point to the benefits of having a microbiome with the right bacteria, in the right amount and in the right place, sometimes women with endometriosis can have a reaction to fermented foods. This can be caused by histimine reaction (an uncommon symptom of endometriosis) or something else. But do pay attention and heed your body’s response.

Creation of New Imbalances

While a probiotic can feel like a simple solution to your pain, your gut microbiome is incredibly unique to you as an individual. If you tolerate homemade ferments, my own personal opinion is to start there. Otherwise I would recommend you speak with a health professional about adding probiotics into your routine. Testing your gut microbiome might be a good place to start.

Others disagree with testing of the GI to assess one’s gut bacteria and believe that is bloating and pain are present, the gut is probably imbalanced. In other words, symptomology over testing.

Still others are opposed to adding probiotics into a diet such as in conditions outlined in The Nemecheck Protocol by Dr. Nemecheck.

This isn’t to say a probiotic will mess up your gut, but you do want to use caution before jumping into something.


You read some rather compelling reasons as to why to include good bacteria in your healing toolkit. These include building the immune system, reducing uncomfortable symptoms, and regulating mood and motivation. Recent research studies have shown that they can help lower pain associated with endometriosis symptoms, as well as enhance your overall fertility.

Before making healthcare decisions, make sure to weigh your options and understand any potential drawbacks.


Itoh, Hiroyuki, et al. “Lactobacillus Gasseri OLL2809 Is Effective Especially on the Menstrual Pain and Dysmenorrhea in Endometriosis Patients: Randomized, Double-Blind, Placebo-Controlled Study.” Cytotechnology, Springer Netherlands, Mar. 2011,

Chenoll, Empar, et al. “Selection of New Probiotics for Endometrial Health.” Frontiers in Cellular and Infection Microbiology, Frontiers Media S.A., 17 Apr. 2019,

Moreno I;Codoñer FM;Vilella F;Valbuena D;Martinez-Blanch JF;Jimenez-Almazán J;Alonso R;Alamá P;Remohí J;Pellicer A;Ramon D;Simon C; “Evidence That the Endometrial Microbiota Has an Effect on Implantation Success or Failure.” American Journal of Obstetrics and Gynecology, U.S. National Library of Medicine,

JM;, Moreno I;Franasiak. “Endometrial Microbiota-New Player in Town.” Fertility and Sterility, U.S. National Library of Medicine,

Yalçın Bahat P;Ayhan I;Üreyen Özdemir E;İnceboz Ü;Oral E; “Dietary Supplements for Treatment of Endometriosis: A Review.” Acta Bio-Medica : Atenei Parmensis, U.S. National Library of Medicine,

“Gut Bacteria Can Influence Your Mood, Thoughts, and Brain.” Psychology Today, Sussex Publishers,

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