Study shows menstrual blood can be used to detect endometriosis

In her twenties, Christie Reuter experienced cramps and heavy periods that worsened over time.

“I was in so much pain that I knew something was wrong,” the 37-year-old from West Islip, New York told TODAY. “It’s hard to live everyday life just in pain, knowing it’s more than a week of cramping. I also have pain when I ovulate and sometimes I have random pain for no reason.

A doctor suspected endometriosis and suggested a laparoscopy to diagnose it. This operation confirmed that she had endometriosis, but this doctor did not remove it – called excision. This meant his symptoms persisted as the disease progressed. The doctor also prescribed her a drug to suppress her hormones, but the side effects were terrible and she stopped taking it after three months.

“It was absolutely awful,” she said. “I had looked online and found the reviews saying it was awful and my doctor encouraged me not to worry about it.”

After this experience, Reuters found another doctor who excised his endometriosis. By then the disease had grown outside of her intestines, uterus, fallopian tubes and caused some of her organs to stick together, intensifying her pain. Although she felt relief after her 2017 operation, the pain returned and her doctor thinks more endometriosis could have developed.

“I still suffer a lot. It always pushes back fundamentally. At some point I will probably need a hysterectomy,” she said. “It’s worrying for me because I’m almost 38 and I want to be able to try to have children and it’s more difficult for people with endometriosis.”

Diagnose endometriosis

It took years for Reuter to be diagnosed and treated for endometriosis, which sadly remains common. Endometriosis affects about 11% of women, according to the US Office of Health and Human Services on Women’s Health. It takes up to 10 years to be diagnosed, according to the American College of Obstetricians and Gynecologists. The only way to diagnose endometriosis is through surgery, said Christine Metz. But a new study published in the journal BMC Medicine conducted by Metz and colleagues as part of the ROSE study could lead to better ways to screen for the disease.

“One of the biggest problems for people with endometriosis is the time between symptoms and diagnosis. And that could be anywhere from six to 12 years – and I’ve heard even longer,” said Metz, co-director of the Research OutSmarts Endometriosis (ROSE) clinical study, told TODAY “One of the limiting factors that plays into this area is that it requires laparoscopic surgery to define endometriosis, primarily in the cavity pelvic. This method that we propose would be a non-invasive method to identify people at risk of endometriosis.

Metz and her colleagues analyzed menstrual effluent samples from 33 women to see if they could detect a cellular difference between women diagnosed with endometriosis and women who did not. Women with endometriosis had a marker in their menstrual fluid that women without it didn’t.

“This paper that just came out really defines the difference between already diagnosed patients and controls,” said Metz, a professor at the Institute for Molecular Medicine at the Feinstein Institutes for Medical Research. “In the past, to get endometrium you had to do a surgical biopsy and we found that you can indeed get endometrial tissue from menstrual effluent.”

Dr. Megan Billow, who was not involved in the research, said the article provides evidence that there is a distinction between women with and without endometriosis.

“What this study shows is that they were really able to identify differences, at the cellular and molecular level, in women with endometriosis compared to women without it,” said Billow, a physician at the Cleveland Clinic’s OB/GYN & Women’s Health Institute. TODAY. “The impact of studies like this is to help develop tests or biomarkers that we can use that can critically identify women at risk for endometriosis.”

Billow said this could eventually lead to faster diagnosis, which means women can get treatment sooner.

Billow said the downside of the study is that it only involved a few participants.

“The biggest limitation is the small sample size and understanding the clinical significance of that,” Billow said. “We know that’s what the differences between the two groups were, but how can we use that to develop a test?”

Metz said the ROSE study is continuing and is looking at women with symptoms but no diagnosis compared to those without endometriosis to see if they can discern a difference. She hopes that further research will lead to better detection of the disease and possibly better treatment. Only excision treats endometriosis but the disease can continue to occur even after surgery.

“We hope to study aspects of endometriosis through menstrual effluent, which would guide us toward better therapies,” Metz said. “We hope that having a method for early detection could lead to clinical trials to test new agents or existing agents more aggressively.”

Reuter participated in the ROSE study after her surgery in 2017 and feels grateful to be able to help others avoid what she went through.

“It’s very gratifying because there’s so much pain there’s very little light at the end of the tunnel,” she said. “It’s an incredible breakthrough that will help a lot of people.”

Leave a Comment