For years, endometriosis has been treated mainly as a hormone problem.

Estrogen.
Inflammation.
Lesions.‍

But scientists recently found something unusual in the pelvic fluid of women with endometriosis: lower levels of GLP-1, a metabolic hormone best known for its role in medications like Ozempic and Wegovy.

This discovery has raised a new question for researchers: could metabolism influence the immune environment of endometriosis?

But GLP-1 affects more than metabolism.

It may also influence immune activity and inflammation — two processes strongly involved in endometriosis.

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What Is GLP-1?

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GLP-1 is a metabolic hormone that helps regulate blood sugar and appetite. New research suggests GLP-1 may also influence immune activity and inflammation. Because endometriosis involves immune dysfunction and chronic inflammation, scientists are studying whether metabolic signals like GLP-1 help shape the disease environment.

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GLP-1 (glucagon-like peptide-1) is a hormone released by the gut after eating.

It helps regulate:

• blood sugar
• insulin release
• appetite and satiety

Because of these effects, GLP-1 is widely used in medications for type 2 diabetes and weight management.

But scientists now know GLP-1 receptors exist in many tissues, including immune cells.

This means GLP-1 signalling may influence inflammation and immune behaviour throughout the body.

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A Study Found Lower GLP-1 Levels in Endometriosis

A 2022 study published in Frontiers in Endocrinology examined peritoneal fluid from women undergoing laparoscopic surgery.

Researchers compared women with endometriosis to those without the disease.

They found two key differences.

Women with endometriosis had:

• lower GLP-1 levels in pelvic fluid
• changes in immune cell markers

This finding suggests metabolic signals may influence the immune environment around endometriosis lesions.

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Why the Immune System Matters in Endometriosis

Endometriosis isn’t just about hormones.

The immune system plays a major role.

Normally, immune cells remove misplaced tissue from the pelvic cavity.

But in endometriosis, this process appears to fail.

One important immune cell involved is the macrophage.

Macrophages act like the body’s clean-up crew.

They help:

• remove damaged cells
• regulate inflammation
• repair tissue

In endometriosis, however, macrophages often behave differently.

Instead of clearing abnormal tissue, they may help create conditions that allow lesions to survive.

These cells can promote:

• inflammation
• blood vessel growth
• scar tissue formation

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How GLP-1 May Influence Immune Cells

Because immune cells respond strongly to metabolic signals, researchers are now exploring whether metabolic hormones like GLP-1 may influence immune behaviour in endometriosis.

Macrophages in particular change their behaviour depending on metabolic conditions.

Research shows GLP-1 receptors are present on macrophages and other immune cells.

Experimental studies suggest GLP-1 signalling can:

• reduce inflammatory cytokines
• decrease oxidative stress
• influence macrophage signalling pathways

Some studies show GLP-1 may influence macrophage activity through pathways such as JNK/STAT3 signalling.

In simple terms, metabolic signals like GLP-1 may influence how aggressively immune cells behave around endometriosis lesions.

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The Metabolism–Immune Connection in Endometriosis

Scientists now study this connection through a field called immunometabolism.

Immunometabolism looks at how metabolism shapes immune responses.

Instead of acting separately, these systems constantly interact.

In endometriosis, researchers believe the disease may involve a feedback loop between:

metabolism
immune activity
inflammation

Metabolic signals help determine how immune cells behave. If those signals promote inflammation, they may help create the conditions that allow endometriosis lesions to survive and grow instead of being cleared by the immune system.

And GLP-1 is one of the metabolic signals researchers are now investigating.

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Could GLP-1 Medications Help Endometriosis?

Because GLP-1 signalling influences both metabolism and immune activity, researchers are beginning to explore whether therapies that affect this pathway could influence diseases like endometriosis.

GLP-1 medications are now widely used for diabetes and weight management, many people wonder whether they could affect endometriosis symptoms.

At the moment, there is no clinical evidence that GLP-1 drugs treat endometriosis.

However, some clinicians and researchers are beginning to explore whether metabolic therapies could influence the disease.

While formal clinical trials have not yet been completed, anecdotal patient reports and early practitioner observations have generated positive interest in this area.

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Why Metabolism Matters in Endometriosis

At Endo45, we believe endometriosis symptoms are influenced by several biological systems working together, including:

• immune regulation
• metabolic stability
• gut health
• hormone balance
• nervous system function

Supporting these systems together may help calm the inflammatory processes involved and inturn clam symptoms.

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Where Endo45 Fits In

Understanding the science is one step.

Applying it daily is another.

Inside the Endo45 app, the EndoFit Method helps users:

• track symptoms and inflammatory triggers
• monitor pain, fatigue, digestion, and hormonal patterns
• build anti-inflammatory habits that support your metabolic system.
• measure progress with the EndoFit Score

Because when you can see patterns in your symptoms, it becomes easier to understand what actually helps your body.

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Key Takeaways

• Endometriosis involves hormones, immune signalling, inflammation, and metabolism.
• A 2022 study found lower GLP-1 levels in pelvic fluid in women with endometriosis.
• GLP-1 may influence immune cell behaviour and inflammation.
• Scientists are studying the connection between metabolism and endometriosis through immunometabolism.
• More research is needed before GLP-1 therapies could be considered for endometriosis.

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FAQ

Does GLP-1 affect endometriosis?

Early research suggests GLP-1 may influence immune signalling and inflammation in the pelvic environment. However, there is currently no clinical evidence that GLP-1 medications treat endometriosis.

Why are scientists studying metabolism in endometriosis?

Endometriosis involves chronic inflammation and immune dysfunction. Because metabolism influences immune cell behaviour, researchers are exploring whether metabolic signals may shape the disease environment.

Could Ozempic help endometriosis?

There is currently no scientific evidence that Ozempic or other GLP-1 medications treat endometriosis. Research on metabolic pathways in the disease is still ongoing.

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Author

Juliet Oliver is an engineer, endometriosis researcher, and founder of Endo45. After living with stage 4 endometriosis, she created the Endo45 app to help women track symptoms, identify triggers, and take control of their health using science-backed strategies.

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