A number of options currently exist for treating and managing endometriosis. These include hormonal treatments, surgery and pain medication. Hormonal treatments (oral contraceptive pill, or progestins such as an intrauterine device) may be used to suppress the growth of endometrial tissue and stop irregular bleeding. Lesion excision, performed via laparoscopy, may be required to remove endometriosis lesions. In some cases, a hysterectomy may be required to remove severe endometriosis. Pain and anti-inflammatory medication may be prescribed or used to treat and reduce pain and symptoms. Consult your medical professional for advice on treating and managing endometriosis.
Our researchers are examining inherent differences in uterine fluids and tissue samples taken from women with endometriosis to explain why endometriosis occurs. Their work may lead to more effective treatment options with fewer side effects for women.
What do stem cells have to do with endometriosis?
Team: Professor Caroline Gargett
Associate Professor Caroline Gargett’s team was the first in the world to discover adult stem cells in the endometrium (the lining of the uterus). Endometrial adult stem cells are highly regenerative cells with the potential to differentiate into the functional cells of the endometrium that support early embryo development. Now, her group is working to establish how these stem cells (called endometrial epithelial progenitors and mesenchymal stem cells or eMSC) may be involved in establishing endometriosis. They examined whether the endometrial stem cells flow back into the pelvic cavity when a woman has a period. By analysing fluid in the pelvic cavity while women had their period, the team identified that one of the endometrial stem cells survive longer in women with endometriosis than in women who don’t have the condition. They believe that, in women with endometriosis, these stem cells may survive long enough that they can grow and form lesions. The team’s focus is now on finding a biomarker, or distinct gene signature, in these stem cells, which could be used to detect endometriosis in women much earlier. The team is also working to determine whether ‘risk genes’ for endometriosis are present in these stem cells in women with endometriosis, to understand how these genes may cause endometriosis and to help inform an early diagnostic test for endometriosis.
Disrupting the communication of cells to treat endometriosis
Team: Dr James Deane, Dr Fiona Cousins
Like all cells, endometrial cells, found in the lining of the uterus and which are implicated in endometriosis, use signalling pathways to communicate. Endometrial cells use certain pathways to send messages to each other so that they can grow in a coordinated and orderly manner. Two specific signalling pathways found in other stem cells, called Notch and Hedgehog, are overactive in endometriosis and this is likely to encourage endometrial stem cells to grow much too quickly and in the wrong place. Dr James Deane and Dr Fiona Cousins are examining whether targeting or ‘disrupting’ these pathways could be used to prevent the growth of endometriosis lesions. The aim is to stop the messages that drive stem cell activity and prevent the growth of lesions. If this approach is successful in mice, it could potentially be used to treat endometriosis in women.
Can a menstruating mouse help treat endometriosis?
Team: Dr Hayley Dickinson
For a long time, scientists investigating endometriosis have faced a major challenge – few mammals menstruate, meaning the lack of a suitable preclinical model in which to study new endometriosis treatments and diagnostics. In 2016, Dr Hayley Dickinson’s team at Hudson Institute identified the first known menstruating rodent – the spiny mouse, a species of desert rodent native to Africa and the Middle East. Before Dr Dickinson’s team’s discovery, the scientific community widely believed that rodents didn’t get periods. This game-changing discovery will vastly improve research into women’s reproductive health, including gynaecological conditions such as endometriosis. It means that, for the first time, scientists can study menstruation as it occurs naturally in a rodent. Dr Dickinson and her team are now working to investigate endometriosis in the spiny mouse, to find better treatments and diagnostics for this painful and debilitating condition.
Do women with endometriosis shed different endometrial cells to women without endometriosis?
Team: Dr Jemma Evans
Many women will undergo excision surgery to remove endometriosis lesions, only for lesions to re-establish months or years later. A major issue is that we don’t know how lesions are initiated or how they progress. Dr Evans will examine cells from the endometrium to uncover important differences in the way these cells behave between women who have, and don’t have, endometriosis. Dr Evans and her team will look at ways in which these cells replicate within lesions and also how the cells invade – critical cellular behaviours in the establishment of lesions. This project will help to develop an understanding of why some endometrial cells form endometriosis lesions. The cells which exhibit altered behaviour will be further examined by genomic and proteomic methods to uncover new molecular targets which may be modulated to prevent endometriosis from developing or importantly, re-establishing following surgery.