The World Health Organisation estimates that endometriosis affects around one in ten women during their lifetime—roughly the same as the proportion of the global population with diabetes. But whereas doctors understand why diabetes occurs and how to treat it, their understanding of endometriosis is languishing “30 to 40 years” behind, according to Andrew Horne, a professor of gynaecology and reproductive sciences at the University of Edinburgh and president-elect of the World Endometriosis Society. He blames it on a lack of research and awareness, driven by funding shortages.
Things are starting to change. A clinical trial of the first non-hormonal, non-surgical treatment for endometriosis, started in 2023 in Scotland, is showing promising results. Dr Horne says that the trial, which he co-leads, grew out of closer examinations of how endometriosis lesions form. By taking samples from patients during diagnostic laparoscopies, his team found that those with peritoneal endometriosis—meaning disease on the lining of the pelvic cavity, which represents around 80% of cases—had significantly higher levels of a chemical called lactate in their pelvises than those without.
Lactate is produced when the body breaks down glucose (and is also the cause of the uncomfortable stitches that can suddenly strike runners). Its increased presence, the researchers reckoned, suggested a hand in the development of endometriosis lesions, possibly similar to the role lactate plays in helping cancer cells proliferate.
At last, progress is being made on a condition that affects one in ten women. The first new drug for endometriosis in four decades is on the horizon https://t.co/ixwWrB8flC 👇
— The Economist (@TheEconomist) February 8, 2024