Transforming Women's Health

Endometriosis is a serious medical condition in which endometrial tissue grows outside the uterus in the ovaries, fallopian tubes and other organs. These cells then behave in the same way as those that line the womb, building up during the menstrual cycle and then breaking down and bleeding, but unlike the cells that leave the body as a period, this blood is not expelled and can lead to inflammation, severe pain and the formation of scar tissue. This condition and the chronic pain associated with it can then cause fatigue, mental health problems, infertility and adverse social and economic problems, for example, by keeping women out of education and the workplace.

The World Health Organisation has estimated that endometriosis affects 190 million women globally, or 10% of women of reproductive age, and so it is more prevalent than diabetes. It can also affect women from puberty through to the menopause. The US alone incurs an annual cost of between $78 and $119 billion in treating endometriosis patients. The cause of endometriosis is unknown, but it has been linked to genetics and issues with a patient’s immune system.

Within this context, Endometriosis Awareness Month seeks to address a stark reality: a significant portion of the UK public remains unaware of endometriosis, a condition affecting numbers comparable to those of diabetes and asthma among women and those assigned female at birth. Astonishingly, 54% of the population and 74% of men do not know what endometriosis is. This knowledge gap is particularly pronounced among young women aged 16 to 24, with 62% unaware of the condition and nearly half unable to identify any symptoms. Highlighting these statistics is crucial for prompting a change in the public's perception of women's health issues, especially as advocated by entities like Endometriosis UK. Enhancing understanding and support for those living with endometriosis is imperative, steering conversations towards more informed and supportive discourses.

As troubling as this data is, the endometriosis problem is magnified by the fact that it is notoriously difficult to diagnose. In the UK, for example, it typically takes eight years and 10 GP visits from the first consultation to a confirmed diagnosis, which often requires a surgical procedure under general anaesthetic. Clearly, this is a huge problem, and like so many other issues in women’s health, there is considerable unmet need.

Recently, and not before time, endometriosis has been receiving more attention in medical and mainstream media. For example, NewScientist recently featured an article on the condition, which focused on the problems sufferers confront in getting an accurate and timely diagnosis. The article reports on a recently completed UK study examining 22 endometriosis studies from 18 countries. The conclusions of the analysis are shocking. It found that patients have to wait, on average, 6.6 years to get a diagnosis, but with huge variation between countries. For example, one study found that the diagnostic delay in Brazil is just six months, compared to 27 years in the UK. In the US, the average delay is 11 years, compared to just 1.5 years in Australia, where a national action plan to improve endometriosis care was announced in 2018.

When investigating why these delays occur, the researchers found a general lack of knowledge of endometriosis among both medical professionals and women with the condition’s symptoms. They also found that women with endometriosis say that they feel unheard and that their symptoms are too often dismissed. Five studies reported that in some countries, patients see an average of 4 doctors before they are finally diagnosed.

Perhaps unsurprisingly, and in common with many women’s health issues, endometriosis research comprised just 0.038% of the US National Institutes of Health’s budget, despite the condition affecting at least 11% of US women. In contrast, 12% of US women have diabetes, which received 15 times more funding.

Clearly, more direct funding of endometriosis research, better training of medical professionals and greater awareness are all required to create an environment where women with this condition do not need to go through hell before getting the help that they need. There are hopeful signs on the first of these points, with multiple studies recently being completed and one notable one undertaken by researchers at the University of Oxford in collaboration with 25 teams worldwide. This study examined DNA from 60,000 women with endometriosis and over 700,000 without. It revealed “compelling” evidence of a shared genetic basis for the condition and other types of pain seemingly unrelated to endometriosis, including migraine. The study's results open up new avenues for designing new treatments targeting subtypes of the disease or even the repurposing of existing pain treatments for endometriosis.

However, the most immediate and deliverable improvement in the treatment of endometriosis could come from earlier and better diagnoses, and this is where Verso Biosense may have an important role to play. Verso is an innovative women’s health business that has developed a unique, patented, battery-less, intra-uterine device with embedded sensor technology capable of measuring a woman’s intrauterine environment accurately and continuously. In endometriosis, the uterine temperature can display known clinical anomalies, and it is these anomalies that the Verso device can detect in women with endometriosis symptoms much earlier and more cost-effectively than with current clinical practice.

Verso’s device is also being developed for other indications in women’s health, including, initially, fertility monitoring and as a smart IUD, and subsequently for menopause tracking, PCOS (polycystic ovary syndrome) diagnosis and as an intrauterine glucose sensor for diabetes.

It seems that, at last, the future for women struggling with this disease is beginning to look brighter with the promise of earlier and better diagnosis of endometriosis and better therapeutics to treat it.