Current Research in Endometriosis

Endometriosis affects roughly 190 million women and girls (assigned female at birth) worldwide. Despite its significant impact on the health of the individual due to both the disease and overlapping pain conditions, research funding for endometriosis lags behind other common diseases. However, we are starting to see small improvements. For example, in 2020, research funding by the NIH (National Institutes for Health) for endometriosis was 14 million dollars (US) and in 2022 nearly doubled at 27 million, and it is estimated for 2023 and 2024 to be approximately 29 million dollars. 

The economic burden of endometriosis on the U.S. alone, in terms of medical care and lost productivity, is estimated to be around $78-120 billion annually. These figures underscore the urgent need for more research funding and better treatment options for endometriosis. Which is what we have been seeing more recently, research focused on other aspects of the disease and co-morbidities and not just drugs aimed at suppressing hormones. 

Researchers have started to look more broadly and dive deeper into some areas that have only been superficially explored such as the impact of the  microbiome and genetic studies.  While the media has seemed overly excited about the findings and what this  means now, this new research may be the stepping stones we need to better understand the variations of this disease and future treatments for managing endometriosis along with the overlapping symptoms. 

This article aims at reviewing the new research in endometriosis. 

Please note that this is a brief overview of some of the research, not opinions or endorsements from the iCareBetter team. More extensive research is needed in these areas before any conclusions can truly be drawn. 

Here’s what researchers have been studying recently: 

• Dichloroacetate. Researchers from the University of Edinburgh found that treatment with dichloroacetate reduced the size of endometriosis lesions and decreased lactate production, which has been associated with endometriosis manifestation in earlier studies.
  
• Cannabis. The Western Sydney University in Australia is investigating the potential benefits of medical cannabis for endometriosis treatment. The double-blind randomized controlled trial will evaluate whether medicinal cannabis can counter symptoms like pain caused by endometriosis against a placebo. This of course would not be focused on a treatment for endo, but as pain management.
  
• Immune system. It’s been recognized for many years that endometriosis and the immune system are intricately linked. Recent studies have found an overexpressed protein on endometriotic cells which may help drug development.  Startup Fimmcyte is developing an antibody that labels endometriosis cells for clearance by the immune system, which could provide a much-needed non-hormonal therapy for women with endometriosis.
  
• Pelvic floor therapy. Studies have shown that pelvic floor therapy could be key to tackling endometriosis-induced pain, or identifying overlapping pain conditions. In addition to helping manage chronic pelvic pain, pelvic floor therapy has been effective in relieving pain through exercise,  movements, and manual therapies that target the pelvic area. Read more about pelvic floor physical therapy from our recent blog here.
  
• Endometriosis and other inflammatory diseases. Recent research suggests that endometriosis may be linked to other inflammatory and pain-inducing diseases. A study by Celmatix and 23andMe, among others, found that endometriosis may be linked to 11 conditions, including migraine, back, and multisite chronic pain (MCP), and inflammatory conditions like asthma and osteoarthritis.
  
• Biotech and Endometriosis. Several ongoing studies aim to improve our understanding of endometriosis at the genetic level. The Research OutSmarts Endometriosis (ROSE) study is investigating the causes of endometriosis and aims to develop improved diagnostics and treatments for women with the condition.

Despite the challenges faced by researchers and patients alike, these recent developments in endometriosis research are a beacon of hope. As our understanding of this complex condition deepens, we edge closer to more effective treatments and perhaps, one day, a cure for endometriosis. One thing is certain though, endometriosis may be due to several factors which may need different targets. The expanding research into these topics may not seem relevant now, but may pave the way to better understanding of the variations of the disease, resulting in a wider array of therapies in addition to surgery for both treatment as well as symptom management.  

Related Reading:

1. Genetic Study On Patients With Confirmed or Suspected Endometriosis; Next Gen Jane
2. Unraveling the Connection Between Endometriosis and Autoimmune Diseases
3. The Hidden Connection Between Endometriosis and Systemic Lupus Erythematosus
4. Genetics and Epigenetics of Endometriosis: Unraveling the Complex Web of Hereditary Implications

References:

1. Endometriosis Clinical Trials – Mayo Clinic Research
2. Giudice, L.C., Horne, A.W. & Missmer, S.A. Time for global health policy and research leaders to prioritize endometriosis. Nat Commun 14, 8028 (2023). https://doi.org/10.1038/s41467-023-43913-9