Endometriosis: Impacts & 4 Innovations to Know About
Written by Kamala Payyapilly Thiruvenkatanathan, Ph.D. candidate, Pennsylvania State University.
Endometriosis is a gynecological condition in which tissue similar to the lining of the uterus grows outside the uterus causing pain and inflammation. It is believed to be one of the most common gynecological conditions affecting roughly 10% of reproductive-age women or 190 million females globally.
Despite its prevalence, general awareness of endometriosis is quite low among patients and providers resulting in misdiagnosis and late diagnosis. Many patients can suffer for as long as 10 years, with painful symptoms, before realizing they have endometriosis.
Today, we do not know what causes endometriosis and have very few diagnostic or treatment options available. The world health organization reports that endometriosis is an under-researched condition that requires greater awareness to ensure preventive measures, early diagnosis, and better management.
The causes of endometriosis are thought to be primarily biological, stemming from various internal bodily activities that lead to the growth of endometrial tissue outside the uterus. Other factors contributing to the growth of endometrial tissue may include hormonal influences, impaired immunity, genetics, and environmental contaminants. Potential risk factors or early symptoms include menstrual irregularities such as the early onset of menstruation or longer and heavier periods.
The presence of endometriosis is often identified through a lengthy multi-step process which begins with the healthcare practitioner’s review of menstrual symptoms and recognizing abnormalities in the menstrual cycle or the presence of chronic pelvic pain. This can be followed by several non-invasive tests such as an ultrasound of the pelvic region to look for cysts or other abnormalities.
Unfortunately, the only conclusive procedure for diagnosing endometriosis today requires patients to be put under anesthesia for laparoscopic surgery and biopsy. Diagnosis is also often delayed owing to the underlying presumption that menstrual cramps and associated pain are normal, consistent with health disparities women encounter for pain complaints in general.
Since there is currently no cure for endometriosis, available interventions focus on symptom management and reducing the severity of the disease. This may include medications that aim to inhibit tissue growth and, in severe cases, surgery to remove existing excess tissue although it is highly likely to grow back. Patients with endometriosis are also often prescribed medications for pain management.
The most common symptoms of endometriosis include:
painful menstrual cramps
chronic lower back
pelvic pain
pain during intercourse
painful urination
abdominal bloating and nausea
intestinal pain
painful bowel movements
bleeding or spotting between menstrual periods
Endometriosis predominantly impacts women during their reproductive years and can lead to infertility. As high as 50% of women face difficulties in getting pregnant, and about 40% of women diagnosed with infertility have endometriosis.
Unfortunately, even after surgical interventions, the likelihood of regrowth can necessitate in vitro fertilization (IVF) in order for a successful conception. Further, treatments for endometriosis often involve hormonal prescriptions that may affect ovulation or are contraindicated during pregnancy and breastfeeding, complicating fertility.
For women nearing menopause, symptoms related to endometriosis have been found to disappear. Studies have also found that the pain related to endometriosis subsides after menopause.
Endometriosis impacts the quality of life and overall well-being of women by impeding day-to-day activities, such as attending school or work, due to severe pain, anxiety, and depression. Studies show that endometriosis and related symptoms result in combined direct and indirect costs in the US of an estimated $22 billion per year.
As prioritized by WHO, there is a need for increased awareness and education about endometriosis and its related symptoms, training healthcare practitioners to recognize the presence of the condition early, establishing care pathways that enable seamless transitions between primary healthcare providers and specialized secondary care centers, enhancing the availability of equipment that aids in early diagnosis of endometriosis, and increasing research into endometriosis and potential treatments. It is also important to remember that all of the aforementioned interventions are to be implemented on a global scale, enabling equitable access in low and middle-income countries.
Startup Companies to Watch:
Diagnostic:
Hera BioTech is developing the first tissue-based, non-surgical, molecular test capable of both diagnosing and staging endometriosis.
Treatment:
FimmCyte is developing a first-in-class treatment against endometriosis using novel, safe, and effective, non-hormonal immunotherapies.
Symptom Management:
EMNU Vitae supplements are designed to help manage pain and inflammation by supporting the unique nutritional needs of women with endometriosis.
Industry Innovation:
Organon started a phase 2 trial in Sept 2022 for the OG-6219 drug they obtained through their acquisition of Forendo in 2021. The medication will potentially be used to treat moderate to severe pain related to endometriosis.
About the Author
Kamala Payyapilly Thiruvenkatanathan, Ph.D. candidate, is a human-computer interaction researcher working at the intersection of women's health and technology, with a specific focus on designing for the neglected felt experiences of women navigating pregnancy after loss.
