Gut-reproduction axis: a new perspective on understanding pelvic inflammatory disease

When exploring the macro trend of declining global fertility rates, a pathological factor often hidden beneath individual suffering cannot be ignored: pelvic inflammatory disease (PID). Recurrent inflammation leads to tissue damage, adhesions, and scaring in the fallopian tubes, ovaries, and even the entire pelvic cavity, ultimately causing serious pelvic organ sequelae that severely affect female quality of life. The clinical diagnosis and treatment of PID are very challenging, with issues such as inappropriate treatment plan selection, insufficient treatment duration, and poor patient compliance. The role of microecological balance in maintaining human health has been increasingly recognized. Human tissues and organs form a dynamic, interactive system with microorganisms, playing an important role in female reproductive function. As an important microecological system of the body, the reproductive tract has a relatively complete natural defense function to resist infection. Previous research on the microbiome and female reproductive health has rarely focused on PID. The gut-reproduction axis aims to construct an integrated regulatory model in which the homeostasis of the gut microbiota plays a crucial role in reproductive health. The microbiota affects the occurrence of PID by regulating core pathways, such as hormone secretion, inflammatory responses, and immune homeostasis. Examining the effects of microecologies in animal models and preliminary clinical studies will lay a solid theoretical foundation for developing microbiota-targeted innovative diagnostics and treatment strategies for PID, improving female reproductive health throughout their life course.