Endometriosis from Lyme?

She had the surgery. Then she had it again. Then a third time. After the third procedure, her surgeon looked her in the eye and said — this is just how your body is.

I’ve heard some version of that story more times than I can count. Endometriosis that keeps coming back. Fibroids that return months after treatment. Heavy bleeding that never fully resolves. Miscarriages with no explanation. And at every turn, the same answer: hormones, genetics, stress. Just how your body is.

What nobody in that story ever asked about was the tick bite.

The Research That Changes Everything

A research team led by Dr. Michal Tal at MIT’s Department of Biological Engineering recently published a study that the mainstream OB world hasn’t fully reckoned with yet. Using large-scale electronic health record data, mouse infection models, and corroborating data from a Finnish national database, the team found that Borrelia burgdorferi — the bacterium that causes Lyme disease — significantly increases the risk of multiple gynecological conditions. The numbers are striking. Women with Lyme disease showed a 1.93-fold increased risk of endometriosis, a 1.62-fold increased risk of miscarriage, a 1.42-fold increased risk of uterine fibroids, and a 1.5-fold increased risk of menorrhagia (heavy, prolonged bleeding).

This wasn’t a small survey. It wasn’t anecdote. It was corroborated across multiple data sets, including mouse models where the bacteria were found actively infecting reproductive tissue up to 15 months post-inoculation — long after the initial infection was thought to have resolved.

That last part matters. Borrelia doesn’t just pass through. It persists. And when it persists in the reproductive tract, it creates the kind of chronic inflammation that looks, clinically, like a hormone problem or a structural one — not an infectious one.

The Pattern I Keep Seeing in Practice

I want to be clear: this research is a preprint, meaning it hasn’t completed formal peer review yet. But the data behind it — large EHR datasets, animal models, international validation — is robust. And it confirms what I’ve been seeing clinically for years.

Patients come to me after years of gynecological treatment that hasn’t held. They’ve done everything right. They’ve had the surgeries, followed the protocols, taken the medications. Things improve temporarily, then return. When we dig into the history — really dig in — there’s often a tick exposure, a rash, a period of mysterious illness that everyone moved past without a clear answer. Nobody connected those dots. Nobody was trained to.

That’s not a failure of the physicians who treated these women. It’s a failure of a medical education system that never taught the connection.

Women Are Already Behind in This Diagnosis

Here’s what makes this worse. A study published in the International Journal of General Medicine analyzing data from over 2,170 Lyme patients found that women already face longer diagnostic delays, more severe symptoms, higher rates of misdiagnosis, and greater functional impairment than men with the same infection. Research from the Johns Hopkins Lyme Disease Research Center confirms that women with persistent Lyme are more likely to receive an alternative diagnosis for their symptoms — meaning the real problem gets labeled as something else, treatment gets delayed, and the infection keeps doing damage.

Add gynecological symptoms to that picture and you have a perfect storm: a woman with undetected Lyme disease, endometriosis or fibroids that keep returning, and a medical system that is looking at each problem in isolation. Nobody is looking at the whole person.

The Inflammation Connection

Borrelia is what I’d call a “stealth” infection. It survives in the body by evading immune detection — changing form, hiding in tissue, and triggering a low-grade but persistent inflammatory response. Research on its morphological variants has shown it can shift between spirochete, cyst, and biofilm-like forms, each requiring different approaches to treatment and each capable of sustaining chronic inflammation.

That chronic inflammatory state is the probable driver of the gynecological pathology. Endometriosis, fibroids, and menorrhagia are all inflammatory conditions at their core. If there’s an active infection sustaining that inflammation, treating the structural result — without addressing the underlying infection — is like mopping up a flood without turning off the tap.

What This Means for You

If you’re a woman who has been treated for endometriosis, fibroids, heavy bleeding, or unexplained miscarriage — especially if those conditions have returned despite treatment — I want you to ask a different question. Not just what is this, but what might be driving it.

A tick exposure, even years ago, is worth mentioning to your doctor. A thorough tick-borne illness workup — one that goes beyond the basic CDC two-tier test — is worth having. Lyme-literate physicians are trained to look at the whole picture, including the inflammatory and hormonal disruption that persistent infection creates.

The research is still evolving. But the clinical pattern is real, and there is a path forward. Treating the infection changes the picture in a way that no amount of surgery or hormone therapy alone ever could.

You deserve a fully licensed healthcare practitioner who’s asking all the questions. Not just the ones that fit the standard algorithm. Look for one who has completed the Moorcroft Lyme Disease Practitioner Certification & Mentorship (LDPC) program to ensure they have the highest level of expertise to help you navigate your path back to health.

— Dr. Tom

References

1. Tal MC, Hansen Colburn P, et al. “Lyme disease increases risk for multiple gynecological conditions.” medRxiv preprint, March 2025. doi:10.1101/2025.03.03.25323258
2. Johnson L, Shapiro M, Janicki S, et al. “Gender disparities in Lyme disease: women face higher risk of severe and prolonged illness.” International Journal of General Medicine, 2023. Published by LymeDisease.org / MyLymeData registry (n=2,170).
3. Johns Hopkins Lyme Disease Research Center. “Sex- and gender-based differences in Lyme disease.” hopkinslyme.org, updated 2024.
4. Flisiak R, et al. “Perinatal transmission of Borrelia burgdorferi: advancing scientific and clinical understanding of Lyme disease in pregnancy.” Frontiers in Medicine, February 2026. doi:10.3389/fmed.2026.1794120
5. Rudenko N, et al. “Proteomic analyses of morphological variants of Borrelia burgdorferi shed new light on persistence mechanisms: implications for pathogenesis, diagnosis and treatment.” bioRxiv, 2019. doi:10.1101/501080
6. Stricker RB, Johnson L. “Implications of gender in chronic Lyme disease.” Journal of Women’s Health, 2009;18(10):1717–1720. PMID: 19514824