Tuesday, 30 April 2013

Research Roundup



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!