Your endometriosis questions answered

Hudson Institute researchers Professor Caroline Gargett, Dr Caitlin Filby and Dr Fiona Cousins are investigating the potential causes of endometriosis. If we can understand more about how endometriosis emerges and develops, this could lead to the development of less invasive diagnostic tests and more effective treatments.

What is endometriosis?

Endometriosis or ‘endo’ is a debilitating, chronic inflammatory condition where tissue fragments with similar properties to the womb lining attach to other organs and grow into lesions outside the uterus. Initially, these lesions are still responsive to female reproductive hormones that trigger menstruation and may bleed during a woman’s period, causing inflammation. The conditions can cause chronic pelvic pain, bowel and bladder dysfunction, back pain, heavy menstrual bleeding, nausea, pain during sex, and infertility. There is no cure. Treatments include hormonal based therapies and surgery to remove lesions to reduce pain and improve fertility. But much better treatments are needed.

What causes endometriosis?

This is the key question facing endometriosis researchers today. We are working on the hypothesis that endometriosis is caused by retrograde menstruation – where menstrual fluid containing cells that initiate endometriosis flows backward through the uterus, out of the fallopian tubes and into the pelvic cavity. These cells somehow evade the immune system, attach to organs, and form lesions.

What does your research involve?

We believe there are two types of endometrial stem cells shed during menstruation that could be forming lesions following retrograde menstruation into the pelvic cavity. The ability for stem cells to grow and proliferate are qualities that enable the endometrium – the lining of the uterus – to renew each month after shedding during the menstrual cycle.

This is a disease affecting young women in the prime of their lives. It prevents them from reaching their full potential – personally, professionally, financially. We desperately need new ways to diagnose and treat endo. We want to give the millions of women with endometriosis their quality of life back.” Prof Caroline Gargett

You may wonder then why all women don’t have endometriosis? We believe the answers might be in the DNA of women’s endometrial cells. We are working in collaboration with Professor Grant Montgomery from the University of Queensland to investigate how variations in the DNA sequence (genomics) that give rise to endometriosis risk genes could be giving these stem cells an advantage to grow into lesions. The role of inflammation and the immune system is also important in allowing lesions to survive.

There is an urgent need to improve the lives of women with endometriosis. To achieve this, we need to understand which cells form the lesions, how they spread to other organs, and what factors govern their ability to survive and invade other tissues. This will enable us to develop new therapies that will hopefully prevent endometriosis, saving women from the debilitating pain and discomfort caused by this condition.

Endometriosis Facts

  • Affects 1 in 9 women – 176 million women worldwide
  • Up to 10 years’ wait for diagnosis
  • Annual costs: Australia $9.7 billion | UK GBP 8.5 billion | US $53.8 billion

Collaborators | Professor Grant Montgomery, University of Queensland; Professor Luk Rombauts, Monash IVF
Funders | US Department of Defense, NHMRC

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