The 8th March 2023 marks International Women’s Day, a worldwide celebration of women’s achievements and a call to action for increased gender equality.
This year’s UN theme is ‘DigitALL: Innovation and technology for gender equality’, which aims to spotlight women’s achievements in digital innovation and boost the representation of women in STEM. International Women’s Day also happens to coincide with Endometriosis Awareness Month. With this in mind, this article places a focus on endometriosis and what UK charity, Wellbeing of Women, are doing to find new treatments for it.
What is endometriosis?
Endometriosis is the second most common gynaecological condition in the UK, and affects around 1.5 million women and individuals assigned female at birth. The condition occurs when tissue similar to that which is found in the womb lining grows elsewhere, such the ovaries, fallopian tubes and pelvis. Although the symptoms of endometriosis vary, common symptoms include:
- Pelvic pain (which worsens when menstruating)
- Dysmenorrhea (painful periods)
- Painful sex
- Pain when going to the toilet
- Sickness, constipation and diarrhoea
- Infertility or difficulty getting pregnant
Research suggests that the condition may have increased prevalence in some groups, such as women who have:
- A family history of the condition
- Irregular periods or short cycles
- Ovarian cysts or tumours
- Never given birth
- Heavy periods
There is no cure for endometriosis, but treatments are available which aim to ease the symptoms. These include painkillers (e.g. paracetamol and ibuprofen), hormone medicines and contraceptives, and surgery. However, these options aren’t effective for everyone, and much like any treatments, they do come with side effects.
Emerging research suggests that medical cannabis may be an effective alternative treatment for women suffering from endometriosis. A study conducted in 2021 found that cannabis was effective in significantly reducing chronic pain scores in participants with endometriosis. Another trial carried out last year echoed these findings, with participants reporting a reduction in abdominal pain and an improvement in quality of life.
Monique Ellis, CEO and Founder of Evolv, a biotech and life sciences company focused on female health, is passionate about using innovative cannabinoid products for treating endometriosis.
“Bringing funding into the sector to spearhead new approaches is of significant importance. Advancements in non-hormonal medicine and pioneering technology for the treatment of endometriosis is a must and this is core to our mission at Evolv. Our innovation is focussed on the intersection of cannabinoid-based medication and digital health to provide patients an alternative for personal pain control, improving quality of life for them and those around them.”
Issues with endometriosis diagnosis and treatment
On average it takes around 8 years to be diagnosed with endometriosis, which means that women often suffer for years without appropriate treatment. On their journey to diagnosis, women may encounter multiple misdiagnoses as symptoms are very similar to a number of other conditions. This results in delayed treatment and worsening symptoms.
As well as this, the fact that there is currently no cure for the condition means that the treatment options available are lacking and mainly revolve around managing symptoms, rather than treating the causes. This hugely affects the quality of life of those who suffer with endometriosis.
Janet Lindsay is the Chief Executive of Wellbeing of Women, and feels passionately about the small number of treatment options available to women:
“It is completely unacceptable that there have been no new treatments for endometriosis in 40 years. Too many women and girls are suffering from debilitating symptoms, such as chronic pelvic pain, fatigue and even fertility problems, and current hormonal and surgical treatments aren’t suitable for everyone.”
This lack of treatment options can be attributed to the absence of funding for new research into endometriosis, meaning that no new treatments have been formulated in the last 40 years.
Wellbeing of Women
Wellbeing of Women is a UK health charity dedicated to saving the lives of women, girls, and babies. Led by women’s voices, the charity aims to improve health and wellbeing through research, education, and advocacy, and work towards a world where women’s lives are not limited by their gynaecological and reproductive health.
The charity is working in partnership with the Scottish Government to improve endometriosis treatment and care, which was a key aim of Scotland’s Women’s Health Plan that launched in August 2021.
Wellbeing of Women is the only charity in the UK to fund research, education, and advocacy in relation to women’s gynaecological and reproductive health. To date, the charity has invested over £990,000 into endometriosis research.
Wellbeing of Women’s previous research has found that the cells from the pelvic wall of women behave differently than the cells of those in women without the condition. As well as this, researchers have also found that these cells produce higher amounts of lactate, a chemical generated by the body to give us energy when there is a lack of oxygen. This then creates an environment that sustains the growth and development of the condition.
However, when the endometriosis cells were treated with a drug called dichloroacetate, the production levels of lactate returned to normal, and the size of the endometriosis lesions were reduced. Following this initial research, a small trial of 30 participants received treatment with dichloroacetate and reported less painful symptoms and needed fewer painkillers.
Stemming from this trial, Wellbeing of Women have now announced that in partnership with the Scottish Government, they will be awarding £250,000 to researchers to further investigate whether the treatment can be effective for women with endometriosis.
Researchers from the Universities of Edinburgh, Aberdeen, and Birmingham will run the clinical trial, called EPIC2. It’s set to involve around 100 women with endometriosis in Edinburgh and London, and will investigate the effectiveness of the drug in tackling symptoms and limiting side effects. As well as this, researchers hope to confirm an optimum dose of dichloroacetate.
Dr Lucy Whitaker is a researcher at Wellbeing of Women and a Clinical Lecturer in Obstetrics and Gynaecology at The MRC Centre for Reproductive Health, University of Edinburgh. She will be leading the research, and had this to say:
“We’re grateful to Wellbeing of Women and the Scottish Government for giving us the opportunity to progress our research and hopefully move another step closer to the reality of a new, non-hormonal and non-invasive endometriosis treatment.”
“We know women with endometriosis desperately want more treatment options and better ways to manage the often-debilitating pain that it causes. Our research so far shows promising results that dichloroacetate can make a huge difference. I hope our new trial will confirm this and give women hope that new treatments and a better quality of life are on the horizon.”
If successful, the new drug would be the first ever non-hormonal and non-surgical treatment for endometriosis, as well as the first new treatment in 40 years. Not only does the research carry the potential to diversify the treatments available to women, but it also aims to move towards more personalised medicine. The dose of dichloroacetate given to each participant will differ based on which version of a gene called GSTZ1 they carry. This gene is responsible for the speed at which the drug is metabolised; to limit the risk of side effects the dosage must be tailored to avoid a build-up of dichloroacetate in the bloodstream.
It’s clear that Janet is positive about dichloroacetate’s potential as a new treatment for endometriosis, especially considering the barriers that research has previously faced:
“Endometriosis is an extremely under-funded area of women’s health, so we are very pleased to partner with the Scottish Government and invest in medical research that could transform how the condition is treated for millions of women. Dichloroacetate has the potential to be the very first non-hormonal and non-invasive treatment for endometriosis, which will be truly ground-breaking. With limited options currently available and no cure, advances like this are long overdue.”
There is no doubt that emerging treatments for endometriosis such as dichloroacetate and medical cannabis represent hope and relief for millions of women and individuals assigned female at birth across the UK. However, to ensure treatments continue to develop there is a real need for increased investment in women’s health and wellbeing.
All that’s left to say is happy International Women’s Day from all of us at Volteface!