摘要Background:Endometriosis is a chronic disease that affects women in reproductive age,and adeno-myosis was known as"endometriosis in the uterus".Endometriosis is an immune-dysfunction-related disease,contributing to the diversity of microbiota in the lower genital tract.Endometriosis is also an infection-related disease,the number of bacteria may contribute to some unknown mechanisms.Pres-ently,the feature of microbiota between endometriosis patients and normal people is not fully understood.Methods:To identify the microbiota differences and features of endometriosis patients,298 samples from the cervical canal,posterior fornix of the vagina and uterine cavity were analyzed by 16s-rRNA sequencing.Raw data were filtered,analyzed,and visualized.We conducted diversity analysis,statistical data of microbiota abundance,biomarker identification,random forest,and environmental factors analysis.Results:Alpha diversity was not distinctive in endometriosis and adenomyosis patients.Posterior fornix near cervix was a better sampling location to analyze the dysmenorrhea-related microbiota feature;few dysmenorrhea-related bacteria were identified.Endometrial bacteria is controversial,and the result of 16s-rRNA sequencing was not good enough to conduct further analysis.Anaerococcus was a possible biomarker of adenomyosis-endometriosis patients.The identified bacteria were representative only in specific periods during the menstrual cycle.GnRH-a treatment impacted microbiota feature the most compared with other environmental factors.Conclusion:This study provided us with a new concept of endometriosis and bacteria;different microbiota features may relate to endometriosis.The bacterial involvement should be considered in the future study of endometriosis.New non-invasive diagnosis and therapeutic methods through bacterial medication are prospective.