Endometriosis affects an estimated
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.
Pain management is the main goal of most treatments for endometriosis. Both prescription and over-the-counter pain medications and hormone therapies are often recommended. Surgery is also a treatment option.
New oral medication
In the summer of 2018, the U.S. Food and Drug Administration (FDA) approved the first oral gonadotropin-releasing hormone (GnRH) antagonist to help women with moderate to severe pain from endometriosis.
Elagolix is a
It’s important to note that GnRH antagonists essentially put the body into an artificial menopause. That means side effects may include loss of bone density, hot flashes, or vaginal dryness, among others.
Surgical options and upcoming clinical trial
The Endometriosis Foundation of America considers laparoscopic excision surgery to be the gold standard for surgical treatment of the condition. The goal of the surgery 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 new clinical trial 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. A new clinical trial is exploring the use 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 between roughly 7 and 10 years to diagnose. The lack of non-invasive diagnosis tests is one of the reasons behind that lengthy time.
That may change someday. Recently, scientists with the Feinstein Institute of Medical Research published a study that suggests tests on menstrual blood samples may provide a viable, non-invasive method of diagnosing endometriosis.
The researchers found that the cells in menstrual blood of women with endometriosis have certain characteristics. Specifically, the menstrual blood 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 non-invasive way to diagnose endometriosis.
Research into endometriosis diagnosis and treatment is on-going. Two major — and somewhat sci-fi — studies emerged at the end of 2018:
In a study from Northwestern Medicine, researchers discovered that induced human pluripotent stem (iPS) cells can be “reprogrammed” to transform into healthy, replacement uterine cells. This means that uterine cells causing pain or inflammation can be replaced with the healthy cells.
These cells are created from the woman’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 study finding that the microRNA Let-7b — a genetic precursor that controls gene expressions — is repressed in women with endometriosis. The solution? Administering Let-7b to women may help treat the condition.
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.
If gene therapy does prove effective in humans, it could be a non-surgical, non-invasive, and non-hormonal way to treat endometriosis.
While there is no cure for endometriosis, it’s treatable. Research on the condition, treatment options, and management is on-going. If you’re interested in learning more, talk to your doctor. They can answer your questions and suggest resources for finding out more.