There’s no cure for endometriosis, which is a historically underfunded area of medical research. Scientists are pushing for more funding to study endometriosis and how it can best be treated.
Endometriosis is a chronic condition where tissue similar to uterine lining grows outside the uterus. It’s known for symptoms like pelvic pain, bleeding and spotting between menstrual periods, and digestive issues. For some, it can lead to infertility.
According to research, endometriosis affects an estimated
Historically, research gaps have meant there’s a lot that’s still unknown about endometriosis. In recent years, a growing body of research has examined the possible causes of endometriosis, non-invasive methods used to diagnosis the condition, and long-term treatment options. Read on to learn about the latest advancements.
There’s no cure for endometriosis. Available treatments do not address the endometriosis itself, but instead aim to alleviate corresponding symptoms.
Currently, pain management is the main treatment goal for endometriosis. Both prescription and over-the-counter pain medications and hormone therapies are often recommended. Surgery is also a treatment option.
New oral medications and clinical trials
In the summer of 2018, the Food and Drug Administration (FDA) approved the first oral gonadotropin-releasing hormone (GnRH) antagonist, called Elagolix (Orilissa), to help with moderate to severe pain from endometriosis.
Elagolix is a
It’s important to note that GnRH antagonists essentially put the body into artificial menopause. That means side effects may include loss of bone density, hot flashes, or vaginal dryness, among others.
Two more oral GnRH antagonists — linzagolix and relugolix (Orgovyx) — are currently being studied in clinical trials for treating endometriosis pain.
Another oral medication, Myfembree, is currently approved to treat heavy menstrual bleeding in those with uterine fibroids. In 2021, the manufacturers applied for approval to treat this symptom in endometriosis as well.
Another clinical trial is underway to assess the use of dichloroacetate (DCA) for treating endometriosis. DCA is currently used to treat metabolic disorders in children.
Preliminary data shows that DCA could help stop the growth and survival of endometriosis cells and reduce lactate production in the pelvis, which women with endometriosis are thought to have more of compared to women without endometriosis.
Cannabis for endometriosis
A 2020 study found that 59 percent of women who reported using cannabis for endometriosis relief were able to stop relying on pain medications, including opioids.
This may be related to increasing evidence that cannabis or cannabinoids help restore imbalances in the endocannabinoid system that are thought to contribute to endometriosis symptoms.
Pelvic floor physical therapy
Pelvic floor physical therapy is increasing in popularity among those with endometriosis. Research from a
The Endometriosis Foundation of America considers laparoscopic excision surgery to be the gold standard for surgical treatment of the condition (and to confirm a formal diagnosis). The goal of the surgery as treatment is to remove endometrial lesions while preserving healthy tissue.
Surgery can be successful at reducing endometriosis-related pain, notes a review in the journal Women’s Health. It’s even possible, with pre-informed consent, for a surgeon to perform excision surgery to treat endometriosis as part of the same procedure to diagnosis the condition.
A 2018 study involving more than 4,000 participants found that laparoscopic excision surgery was also effective at treating pelvic pain and bowel-related symptoms of endometriosis.
A clinical trial underway in the Netherlands aims to make surgery even more effective. One issue with current surgical approaches is that if endometriosis lesions aren’t removed completely, symptoms can come back. When this happens, the surgery may need to be repeated. This clinical trial is exploring the use of fluorescence imaging to help prevent the need for repeated surgeries.
From pelvic exams to ultrasounds to laparoscopic surgery, the most effective methods of diagnosing endometriosis are fairly invasive. Many doctors can diagnose endometriosis based on medical history and a physical examination. However, laparoscopic surgery — which involves inserting a small camera to examine endometrial scarring — is still the preferred method of diagnosis.
Endometriosis can take
That may change someday. In 2018, scientists with the Feinstein Institute of Medical Research published a
The researchers found that the cells in the menstrual blood of those with endometriosis have certain characteristics. Specifically, it contains fewer uterine natural killer cells. It also tended to have stem cells with impaired “decidualization,” the process that prepares the uterus for pregnancy.
More research is needed. But it’s possible that these markers may one day provide a quick and noninvasive way to diagnose endometriosis.
Research into endometriosis diagnosis and treatment is ongoing. Two major — and somewhat sci-fi — possibilities have emerged in recent years.
These cells are created from the person’s own supply of iPS cells. That means there’s no risk of organ rejection, as there is with other types of transplants.
More research is needed. But there’s potential for cell-based therapy to be a long-term solution to endometriosis.
The cause of endometriosis is still unknown. Some research suggests that the suppression of specific genes may play a part.
Scientists at Yale University published a
So far, the treatment has only been shown to be effective in mice. Researchers saw big reductions in endometrial lesions after injecting mice with Let-7b. More research is needed before testing in humans.
Another 2021 study found DNA variations in the gene that produces the protein neuropeptide S receptor 1 (NPSR1) occur more often in women with endometriosis compared to those without the condition. NPSR1 is thought to play a role in endometriosis-related inflammation.
The drug used in the study to shut down NPSR1 activity was effective in mice but is not approved for use in humans. More research is needed to develop a similar option for use in humans that may help treat endometriosis.
If gene therapy does prove effective in humans, it could be a nonsurgical, noninvasive, and nonhormonal way to treat endometriosis.
While there’s no cure for endometriosis, available treatment options can help alleviate symptoms. And more options are on the horizon, as research on the condition, treatment options, and management is ongoing.
If you’re interested in learning more, talk with your doctor. They can answer your questions and suggest resources for finding out more.