Despite the exponential progression in medical research within the last few decades, much more research and resources are needed for women’s health issues, like endometriosis, to be treated equally with other fields of medical research.

More recently there has been a persistent call for funding for women’s health research, as awareness of the health gap is being highlighted globally. This includes advocating for more funding for research on menopause and reproductive health, including endometriosis, to generate a better understanding of the conditions and their diagnoses, which is urgently needed to create efficient treatment and care for many women.

The past two years have provided women with a gleam of hope, with breakthrough research on endometriosis coming to light. This includes potential new diagnostic techniques and the development of a drug which may treat the disease.

What is endometriosis?

March is .  Endometriosis is a debilitating condition affecting women and girls all across the world. It involves uterine tissue growing in other places of the body other than the uterus, often causing symptoms including severe pelvic pain, irregular periods, fatigue and infertility.

Despite the disease affecting around 10% of women and girls at reproductive age, diagnosis takes an exceptionally long time. This is in part due to the complicated nature of the condition, and its symptoms often overlapping with other lower abdominal disorders. Other factors include limited resources in low-to-middle-income countries and a lack of efficient knowledge across the board surrounding the condition.

For example, in the UK, it takes an average of 7.5 years to diagnose someone with endometriosis. The only currently approved method to get diagnosed is through a minimally invasive surgical procedure called a laparoscopy to confirm the presence of endometrial tissue outside of the uterus.

Diagnosing endometriosis

Ultrasounds and MRIs can be used to detect more superficial lesions; however, deeper abdominal cysts require surgical intervention. This method is the current ‘gold standard’ to diagnose women with the condition, but it is accompanied by complications as with any surgical procedure.

Research on using accurate biological markers to detect the condition would be ideal for quickly and non-invasively diagnosing endometriosis. published in   shows how different biomarkers detected through a liquid biopsy could be potentially used to detect endometriosis.  However, this research requires extensive further study to fully elucidate. Improving diagnosis efficiency is essential to minimise the time it takes to receive treatment and relieve symptoms of patients who are suffering from the condition.

A new imaging technique to improve diagnosis

In 2024, a clinical trial from the University of Oxford presented data which could lead to radically improved diagnosis of endometriosis for women across the globe. The clinical trial is currently ongoing.

The study involves using a specific imaging technique using a marker called 99mTc-maraciclatide. The researchers had 25 participants with endometriosis undergo the scan before their surgery to confirm the presence of lesions. The scan works by detecting specific molecular components called integrins. The findings from the scan were then compared to findings from the surgery.

The preliminary results showed the detection of not only superficial endometrial lesions but also deep endometriosis during the early stages of the disease.

Endometriosis is a common disease affecting many millions of women worldwide with pain and infertility. The current delay in diagnosis results in prolonged suffering and uncertainty. Therefore, a novel imaging tool to assist healthcare professionals in identifying or ruling out the disease is urgently needed.
– Professor Christian Becker, Co-Director of the Endometriosis CaRe Centre

These initial results paint a hopeful picture for the future of the clinical trial and for women with endometriosis, potentially putting an end to the extortionate length of time it takes for a woman to receive a diagnosis.

Understanding the cause of endometriosis

For appropriate treatment of endometriosis, researchers need to understand why the condition develops. The exact cause is currently unknown, but there are a few factors which may play a part in the development of the disease. This includes hormonal and genetic factors. A review published in the Open Access provides an up-to-date understanding of the pathophysiology of endometriosis.

Author of the review Dr. Garvey describes how potential immune dysregulations could contribute to the manifestation of the disease. They explain how an increased number of pro-inflammatory components such as natural killer cells, macrophages and the cytokines secreted may be involved in the expansion of endometrial tissue and, hence, the progression of endometriosis.

Furthermore, the study also explores how dysregulation of the gut microbiome could also be linked to the pathology of the disease, which is seen in another review published in the Open Access journal   that provides an in-depth analysis.

The review highlights how recent advancements in transcriptomic analysis have revealed valuable links between gastrointestinal (GI) disorders and female reproductive health issues such as endometriosis. Around 90% of endometriosis patients experience GI symptoms such as bloating, constipation and nausea. This emphasises the importance of understanding the association between the development of endometriosis and GI disorders.

More research is constantly being performed to uncover the mechanisms leading to the development of endometriosis. You can read more about this research in a recent Special Issue: Advanced Research in Endometriosis published in Biomedicines. The Issue includes research published on the pathophysiology, diagnostics and treatment of endometriosis, adding to the limited knowledge on the disease to eventually help those struggling with the painful condition. This includes research on potential new treatments.

Treatment for endometriosis

There is currently no cure for endometriosis. Current first-line treatment involves treating the symptoms of the disease with the use of hormonal contraception to manage and relieve pain.

These contraceptives work by stopping the growth of the tissue induced by the hormone estrogen. Reducing this hormone through contraceptive methods has been successful for the pain management aspect of the disease. However, it is well known that contraceptives may come with many adverse effects which may discourage women from taking hormonal medication.

A new medication known as dichloroacetate (DCA) may be an alternative solution for pain management in those with endometriosis.

Dichloroacetate as a new treatment

Previous research shows how this drug, previously used to treat mitochondrial disorders, could be used to treat endometriosis. In the study, researchers found that pelvic cells from women who had endometriosis exhibited altered mitochondrial function compared to normal cells. Upon treatment with DCA, this function returned to normal and the size of the lesions was reduced in mice models.

Following this, an EPiC clinical trial was carried out to see if DCA could be used to treat endometriosis. The trial involved treating 30 women diagnosed with endometriosis with DCA. The results were positive, with 79% of the participants experiencing reduced pain, 62% of participants using less pain-relief medication and the overall health profile of the participants improved.

This clinical trial enabled the initiation of the second round of EpiC, EPiC2, where researchers aim to determine which dose of DCA can reduce painful endometriosis symptoms with the fewest

If successful, the drug could be the first non-contraceptive treatment for endometriosis, a breakthrough for the medical research community, and a relief for many women struggling with the condition.

More research, more hope

Recent breakthroughs in diagnosing and treating endometriosis offer women the hope that their condition may be cured one day. For this to happen, more funding is needed to address the knowledge gap surrounding women’s health.

You can read more about the Gender Health Gap here, where we discuss how underfunding women’s health research is detrimental to women across the globe, and explore steps that need to be taken at a government level to address the disparities.

MDPI publish medical research across all fields, including women’s health. To learn more about this research, see articles published in Biomedicines, and Pharmaceuticals, or access the full .