Progress made in understanding causes and treatment of endometriosis

Jan 16, 2009

Endometriosis is a poorly understood chronic disease characterized by infertility and chronic pelvic pain during intercourse. It affects between 5 to 10 million women in the U.S.

Serdar Bulun, M.D., George H. Gardner Professor of Clinical Gynecology at Northwestern University's Feinberg School of Medicine, has spent the past 15 years investigating and identifying the causes of this disease. Bulun, and colleagues in his lab, discovered key epigenetic abnormalities in endometriosis and identified existing chemicals that now help treat it.

Bulun describes his lab's findings over the past 10 years in the Jan. 15 issue of the New England Journal of Medicine.

One of the abnormalities he discovered is the presence of the enzyme aromatase -- which produces estrogen -- in endometriosis, the diseased tissue that exists on pelvic organs and mimics the uterine lining. (Normal endometrium, located in the uterine cavity, does not contain aromatase.) As a result, women with endometriosis have excessive estrogen in this abnormal tissue found on surfaces of pelvic organs such as the ovaries. Bulun found the protein SF1 that produces aromatase, which is supposed to be shut down, is active in endometriosis.

"Estrogen is like fuel for fire in endometriosis," Bulun said. "It triggers the endometriosis and makes it grow fast."

As a result of the aromatase finding, Bulun launched clinical trials in 2004 and 2005 testing aromatase inhibitors -- currently used in breast cancer treatment -- for women with endometriosis. The drug blocks estrogen formation and secondarily improves progesterone responsiveness.

"We came up with a new treatment of choice for post-menopausal women with endometriosis," Bulun said. Moreover, treatment with an aromatase inhibitor is a very good option for premenopausal women with endometriosis not responding to existing treatments, he noted.

Another molecular abnormality Bulun found is that women with endometriosis have a progesterone receptor that is inappropriately turned off. Normal progesterone action would be beneficial because it blocks the growth of endometriosis. In the absence of appropriate progesterone action, endometriosis tissue remains inflamed and continues to grow.

Bulun believes that these abnormalities result from epigenetic defects that occur very early on during embryonic development and may be the result of early exposure to environmental toxins. In fact, other investigators have implicated the environmental pollutant dioxin and the synthetic estrogen DES in the etiology of endometriosis.

"This may be a disease that women are born with," Bulun said. "Perhaps when a baby girl is born, it has already been determined that she is predisposed to have endometriosis. Maybe research can now be directed toward the fetal origins of the disease and raise the awareness of how the disease develops."

Source: Northwestern University

Explore further: Life-prolonging protein could inhibit ageing diseases

Related Stories

Architects to hatch Ecocapsule as low-energy house

17 hours ago

Where people call home depends on varied factors, from poverty level to personal philosophy to vanity to community pressure. Ecocapsule appears to be the result of special factors, a team of architects applying ...

California farmers agree to drastically cut water use

20 hours ago

California farmers who hold some of the state's strongest water rights avoided the threat of deep mandatory cuts when the state accepted their proposal to voluntarily reduce consumption by 25 percent amid ...

Apple may deliver ways to rev up the iPad, report says

21 hours ago

MacRumors last month said that the latest numbers from market research firm IDC's Worldwide Quarterly Tablet Tracker revealed Apple stayed on as the largest vendor in a declining tablet market. The iPad ...

Recommended for you

Life-prolonging protein could inhibit ageing diseases

May 29, 2015

Researchers have found a molecule that plays a key link between dietary restriction and longevity in mammals. This discovery may lead to the development of new therapies to inhibit age-related diseases.

How sleep helps us learn and memorize

May 28, 2015

Sleep is important for long lasting memories, particularly during this exam season. Research publishing in PLOS Computational Biology suggests that sleeping triggers the synapses in our brain to both streng ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.