Vaginal microbiota #24

Gut–mind–pelvic axis: New insights from microbiome science

Beyond surgery, hormones and tumor staging, women with endometrial cancer often experience persistent symptoms affecting mental health, gastrointestinal comfort and sexual well-being. A recent study from the University of Oklahoma suggests that the gut and vaginal microbiota may contribute to these quality-oflife outcomes.

Researchers followed 140 women scheduled for hysterectomy, including patients with endometrial cancer and women with benign gynecological conditions. Before surgery, participants completed validated questionnaires assessing physical and mental health, stress, gastrointestinal symptoms and sexual function. Vaginal and rectal samples were collected for microbiome analysis, enabling correlations between microbial profiles and patient-reported outcomes.

Women with endometrial cancer showed higher vaginal microbial diversity, a pattern usually considered unfavorable in other clinical contexts. Greater diversity was associated with increased vaginal dryness and irritation. Several bacterial species, including Lactobacillus iners, Lactobacillus gasseri and Streptococcus agalactiae, were more frequent in women reporting worse vaginal symptoms, suggesting that oncological conditions may alter vaginal ecosystem dynamics.

The gut microbiota also displayed meaningful associations. In endometrial cancer patients, certain bacterial taxa correlated with better mental well-being, lower stress levels and fewer gastrointestinal complaints, while others were linked to bloating, discomfort or reduced sexual interest.

These findings reinforce the concept of a gut–mind–pelvic axis connecting microbial ecosystems with psychological and pelvic health. From a clinical perspective, this work opens new opportunities for precision microbiome interventions, from targeted probiotics to dietary strategies in supportive cancer care. Microbiome profiling could help identify patients at risk of persistent symptoms and guide personalized interventions, including dietary strategies, lifestyle interventions or targeted microbiota modulation, with the aim of improving quality of life alongside standard oncological treatments.

Gautam NJ, Jimenez NR, Łaniewski P, et al. Microbiome impacts quality of life in patients with endometrial cancer and benign gynecological conditions. Qual Life Res 2025 ; 34: 2935-48.