What is our Estrobolome and how it’s linked to Endometriosis

New research has emerged indicating the gut micro-biome plays an integral role in the regulation of oestrogen levels within our body. This is key when it comes to endo and estrogen metabolism. 

To optimise homeostasis within the gut we need to have a healthy functioning gut.  
When our gut health and micro-biome is balanced we absorb nutrients from our food helping regulate intestinal permeability, optimising the immune system and regulating oestrogen levels. Gut symbiosis is essential to creating a healthy eco-system. 

When inflammation exists within in the gut it starts to wreak havoc creating systemic inflammatory responses. The body enters into high alert- promoting disease and hormone dysfunction, altering the bodies immune response and increasing levels of circulating oestrogen.

In the case of endometriosis, increased estrogen exposure stimulates growth of ectopic tissue and causes an inflammatory response within the cells. Not what we need! This is where the term estrobolome comes in. The estrobolome is a term used to describe the collection of enteric (gut) bacterial microbes. Their job is to metabolise oestrogen. These microbes (Estrobolome) produce beta-glucuronidase. This enzyme alters estrogen into it’s active form, which bind to oestrogen receptors and influence oestrogen-dependent physiological processes. Essentially the more your gut is out of balance (dysbiosis), the more beta-glucuronidase is produced, and the less oestrogen is excreted out of your body. The estrobolome of women with endometriosis – research has shown they have larger numbers of beta-glucuronidase bacteria leading to increased circulation of oestrogen.

How to balance your Estrobolome:

📍 Supplementation with a broad spectrum lactobacillus probiotic has found to normalise microbes in both the gut and female reproductive tract and decrease bacteria that produce beta-glucuronidase
📍 No alcohol
📍 Cruciferous vegetables such as cabbage, broccoli, cauliflower, kale help regulate gut bacteria, supporting and detoxing of oestrogen

Nourishing Fibre and a Diverse Diet

Fibre is one of the most underrated tools when it comes to supporting a healthy estrobolome. Soluble fibre found in foods like oats, flaxseeds, legumes and psyllium husk binds to excess oestrogen in the digestive tract, helping to carry it out of the body through the bowel rather than allowing it to be reabsorbed. Without adequate fibre intake, oestrogen that should be excreted can be reabsorbed back into circulation, adding to the hormonal burden already present with endometriosis.

Diversity matters just as much as quantity. A gut microbiome that thrives on a wide range of plant foods — vegetables, legumes, wholegrains, nuts and seeds — tends to be more resilient and better able to keep beta-glucuronidase-producing bacteria in check. Aiming for 30 or more different plant foods across the week is a simple, practical target that many nutritionists now recommend for gut diversity.

The Role of Fermented Foods

Alongside targeted probiotic supplementation, naturally fermented foods can offer additional support for a balanced gut ecosystem. Foods such as sauerkraut, kimchi, kefir and coconut yoghurt introduce beneficial bacterial strains that may help crowd out less favourable species. While fermented foods shouldn't replace a clinically studied probiotic strain where one is indicated, they can be a valuable everyday addition to an endo-friendly diet.

Managing Stress and Sleep

It's easy to focus purely on diet when discussing gut health, but the gut–brain connection means stress and sleep play a significant role too. Chronic stress alters gut motility, reduces microbial diversity and can increase intestinal permeability — often referred to as "leaky gut." This, in turn, can worsen the systemic inflammation already associated with endometriosis. Prioritising consistent sleep, regular movement and stress-reduction practices such as breathwork, gentle yoga or time outdoors can meaningfully support the gut environment alongside dietary changes.

Hydration and Movement

Two often-overlooked factors in gut and hormone health are hydration and regular movement. Adequate water intake supports healthy bowel motility, which is essential for efficiently clearing metabolised oestrogen from the body rather than allowing it to linger and be reabsorbed. Aiming for consistent water intake throughout the day, rather than large amounts in one sitting, tends to support digestion more effectively.

Movement, too, plays a role. Regular, moderate exercise — such as walking, swimming or low-impact strength training — has been shown to support healthy bowel transit time and may help reduce circulating inflammatory markers. For those managing endometriosis, gentle, consistent movement is often more sustainable and beneficial than high-intensity exercise, which can sometimes place additional stress on the body.

Why This Matters for Endometriosis Management

Because endometriosis is an oestrogen-driven condition, anything that influences how much oestrogen circulates in the body has the potential to influence symptom severity. A dysregulated estrobolome doesn't just affect digestion — it can contribute to the ongoing inflammatory cycle that drives lesion growth and pain. This is why gut health is increasingly being recognised as a key pillar in a holistic approach to managing endometriosis, alongside medical treatment, movement and stress management.

It's important to note that gut and hormone health is highly individual. What works well for one person may not work the same way for another, and the estrobolome is only one piece of a much larger picture. If you're navigating endometriosis, it's always worth speaking with your healthcare provider or a qualified practitioner before starting any new supplement, particularly if you're currently on other medications or treatments.

Final Thoughts

The link between our gut microbiome and oestrogen metabolism is a powerful reminder that endometriosis management often starts from within. By supporting a diverse, well-nourished gut through fibre-rich foods, fermented foods, reduced alcohol intake and targeted probiotic support — alongside good sleep and stress management — you can help your body do what it's designed to do: keep oestrogen levels in balance and reduce the inflammatory load that endometriosis thrives on.

Small, consistent changes to gut health won't replace medical treatment, but they can be a meaningful part of a broader endometriosis management plan.

Amanda is the founder of Angea and has over 12 years of experience working with women to support their health journey. In addition to being a registered doctor of Chinese medicine, Amanda is a yoga teacher and founder of Mindful Pregnancy Yoga Training. Amanda offers acupuncture, Chinese herbal medicine and womb healing treatments at Angea.