A new clue to endometriosis, a painful and poorly understood disease

The contraceptive pill, a hormonal option that stops a person’s menstruation, is one of the treatments for endometriosis. But it is only effective when a person is taking the pill. Once they stop the medication to try to get pregnant, the pain resumes. And since 30 to 50 per cent of people with endometriosis experience infertility, they are likely to spend months trying to get pregnant while living in excruciating pain.

The only “cure” for endometriosis is removing a person’s reproductive organs.

“Medicine puts a Band-Aid on it,” says Allison K. Rodgers, a reproductive endocrinologist at the Fertility Centres of Illinois who was not involved with the study.

“I can give you medicine to stop your periods; I can give you birth control pills; I can give you pain meds; I can cut it out with surgery,” she says. “But we haven’t figured out the why, and once we start figuring out the why, we’ll be able to design targeted approaches for treatment.”

Kondo emphasises that while no conclusive treatments can be derived from this new study, he hopes the discovery will ignite research into more potential therapies.

“If this indeed holds true for other patients, it may be worth investigating the microbiome of patients with endometriosis from a larger population and assessing whether there’s a mix of different infectious agents that cause inflammation and change the tissue to behave like endometriosis,” says Raymond Manohar Anchan, director of the Stem Cell Biology and Regenerative Medicine Research Laboratory at Brigham and Women’s Hospital in Boston.

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Anchan, who specialises in endometriosis, says that he would be “surprised” if this were a complete correlation and that it “warrants more investigation”.

Anchan and Rodgers also note that the sample size is small, and say the study results would not warrant patients being automatically prescribed antibiotics to treat their endometriosis.

Still Rodgers similarly describes the results as “exciting, even though they’re in their infancy”. She and other experts believe it is a jumping-off point for further research.

“Studies like this are exciting – for every 1,000, probably only one goes on to make a giant discovery,” Rodgers says. “But once we can figure out why some people’s endometrial cells are extra sticky, we can look at targets for a cure.”

Washington Post

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