Objective:

To analyze the interaction between gut microbiota and mitochondrial function in gynecological disorders and propose a dual-targeted treatment approach.

Approach:

• Theoretical Framework: The review constructs a hierarchical framework of 'microbiota-metabolomics-mitochondria' to clarify targeted phenotypes in the pathway.
• Disease Correlation Analysis: Analyzes disease-specific correlations among polycystic ovary syndrome, endometriosis, premature ovarian insufficiency, and gynecological malignancies.
• Intervention Plans: Proposes interventions focusing on microbiota to adjust metabolite spectrum and endotoxin levels, and mitochondria-centered interventions to restore energy metabolism.

Key Findings:

• Gut microbiota dysbiosis is present in PCOS, leading to reduced SCFA production and increased mitochondrial oxidative stress.
• In endometriosis, lipopolysaccharide and mitochondrial DNA release can activate chronic inflammation.
• Microbial metabolites can induce mitochondrial apoptosis and metabolic reprogramming in POI and gynecological malignancies.

Interpretation:

The gut microbiota–mitochondria axis is a critical mechanism in the pathogenesis of gynecological diseases, suggesting a need for integrated research approaches.

Limitations:

• Current studies often focus on gut microbiota dysbiosis or mitochondrial damage separately, lacking integration of their mechanisms.
• Limited human clinical interventional evidence exists to support findings.

Conclusion:

The integration of multi-omics technology and targeted interventions may lead to breakthroughs in precision medicine for gynecological diseases.