Fresh from
the success of endometriosis awareness month endometriosis research has
continued apace. Unfortunately I’ve been quite busy lately so I haven’t had
much time to write a detailed overview on any research this month. But, what I
will do is briefly cover some of the highlights of endometriosis research that
has been published over April.
To start us
off is an article
from South Korea looking into the effect of laparoscopic surgery for endo and its
effect on the ability to conceive naturally. This study took 43 infertile women
with endometriosis and followed up their conception rates 12 months after they
underwent laparoscopic surgery to remove their disease. The overall result was
18 out of 43 women (41.9%) had conceived naturally after 12 months. As
fertility issues are a major concern for women with endometriosis it is good to
know surgical intervention can improve the likelihood of conceiving. (You can
read the full article, for free, here)
Next is an
encouraging piece of research
looking at serious investigation into new treatments for the pain associated
with endometriosis. This latest study from Brazil was a Phase II clinical trial
(basically a detailed check to see if a drug works before it is put on the
market) of melatonin for the treatment of endometriosis associated pain symptoms.
You may have heard of melatonin before, it is produced by your body at
different levels during the day and is responsible for telling your body when
to wake up and go to sleep, but it also acts as an anti-inflammatory and
analgesic. Results of this trial showed 10mg melatonin daily for 8 weeks
reduced daily pain scores by 39.8% and dysmenorrhoea (excessively painful
periods) by 38% also reducing the need for taking other pain killers by 80%. As
an added bonus melatonin was also found to improve sleep quality with no severe
side effects.
Next is a
continuation of investigations into the relationship between environmental
pollutants and endometriosis. All the conducted research thus far has failed to
provide any conclusive proof of linking one type of pollutant to endometriosis.
This latest study
hopes to add some weight to the argument by exploring the relationship between Bisphenol A and 14 Phthalate metabolites in
women undergoing laparoscopy or MRI. This study found that, in the women
undergoing MRI, 6 phthalates were associated with a higher likelihood of being
diagnosed with endometriosis. However, in women undergoing laparoscopy and
histological confirmation (which is the superior diagnostic method) only two
phthalates were found to be associated with an increased risk of being
diagnosed with endometriosis. This study highlights the need for researchers to
pay special attention to the way studies are conducted when looking at
environmental exposures and endometriosis. From my own point of view I think it
may be worth looking at younger girls when designing experiments. Every current
study has been focussed on adult women with endometriosis, but if endometriosis
is a condition you are born with (which the current evidence certainly
suggests) then in-utero and early
life exposures to pollutants will be more important.
I have written
before
about the relationship between ovarian endometriosis and ovarian cancer. Having
ovarian endometriosis for a long period of time can increase your risk of
ovarian cancer, but only by a very small percent. Nevertheless some women with
endo may wonder what effects surgical or medical therapy may have on their
ovarian cancer risk. A recent study from Sweden has done
exactly that by examining medical records of women diagnosed with epithelial
ovarian cancer at least one year after being diagnosed with endometriosis and
calculating if surgical or medical therapies had any effect. What this study
found was that women with endometriosis who had a single ovary removed, or had
radical excision of all visible endometriosis, had a significant reduction in
their ovarian cancer risk. This study provides further evidence that complete
removal of all endometriosis should be a number one priority for all doctors
dealing with the disease.
Quicker
surgical intervention for endometriosis can only come from quicker diagnosis of
endometriosis. This could be achieved with non-invasive tests for endometriosis
before laparoscopy - identifying patients with a high likelihood of the disease
in an objective way. I’ve reported previously
about the current progress of non-invasive tests, but these are just stand
alone tests; what if different non-invasive tests were combined? A study from Egypt has
shown that combining a blood test for interleukin-6 (a substance produced in
your body in response to infection or trauma) with a test for nerve fibres in
the endometrium, can push the diagnostic sensitivity for minimal-mild
endometriosis to 100% Clearly more research needs to be done in this area to
validate these results, but in the future multiple tests from a single blood
sample may be able to identify women with endometriosis.
It may seem
fairly obvious to anyone who has any spent any length of time with, or near
anyone with, endometriosis that the disease can severely impact the sufferers
ability to work. However, just knowing its true isn’t enough, in order to
convince policy makers, we need empirical
evidence that endometriosis has an impact on a woman’s ability to work. What
that means is we need scientific studies comparing women with and without endometriosis
to show, in numbers and statistics, the true devastating effect of the disease.
Fortunately there have been studies
in the past conducted for this very reason and now there is another from Denmark. This
study gave questionnaires to 610 women diagnosed with endometriosis and 751
reference women relating to health and work ability. Perhaps unsurprisingly
this study found that endometriosis was associated with more sick days and low
work ability, which in turn was associated with tiredness, daily pain and high
pain levels. All obvious things you would think, but we need studies such as
these to highlight the impact of endometriosis and get society and governments
to take the disease more seriously.
That’s all I’ve
got for this month, don’t forget to follow me on Twitter @EndoUpdateBlog for shorter,
but more frequent, updates!
