Endometriosis research priorities in Australia

Armour, Mike; Ciccia, Donna; Yazdani, Anusch; Rombauts, Luk; Niekerk, Leesa Van; Schubert, Ruth; Abbott, Jason

doi:10.1111/ajo.13699

Cited by 9 publications

(16 citation statements)

References 23 publications

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“…The findings of this study support previous research that highlights the high priority for developing new methods or improving existing tools for non-invasive diagnosis [ 10 , 12 , 17 , 25 ] and research into the causes of endometriosis for the development of a cure [ 10 , 17 ]. In line with previous work [ 26 ], there was significant dissatisfaction with current treatments for endometriosis, including hormonal treatment and surgery, with our participants wanting an urgent shift toward new, non-hormonal treatment options and a more holistic approach to treatment.…”

Section: Discussionsupporting

confidence: 87%

“…Pam (25)(26)(27)(28)(29)(30)(31)(32)(33)(34) explained that a diagnosis that allowed her to know that "you're not insane, and all this isn't just in your head, there's actually something would be a really good place to start." Early detection could ameliorate the feeling of uncertainty around the perceived legitimacy of symptoms prior to the diagnosis.…”

Section: Resultsmentioning

confidence: 99%

“…Early detection could ameliorate the feeling of uncertainty around the perceived legitimacy of symptoms prior to the diagnosis. For Lana (25)(26)(27)(28)(29)(30)(31)(32)(33)(34), this uncertainty was around the outcome of surgery and the hope of receiving a diagnosis given the significant cost associated with such surgery.…”

Section: Resultsmentioning

confidence: 99%

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Unmet Needs of Australians in Endometriosis Research: A Qualitative Study of Research Priorities, Drivers, and Barriers to Participation in People with Endometriosis

Giese,

Gilbert,

Hawkey

et al. 2023

Medicina

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Background and Objectives: Endometriosis causes significant personal and societal burden. Despite this, research funding lags behind other chronic conditions. Determining where to prioritise these limited funds is therefore vital. Research priorities may also differ between individuals with endometriosis and clinicians/researchers. The aim of this research project is to explore research priorities and factors shaping participation in endometriosis research from the perspective of people with endometriosis in Australia. Materials and Methods: Four focus groups involving 30 people with endometriosis were conducted and analysed using qualitative inductive content analysis. Results: Two categories were developed from the data: unmet research needs and motivators and barriers to participation in endometriosis research. Participants expressed interest in developing non-invasive diagnostic tools and a more multidisciplinary or holistic approach to treatment. Participants urgently desired research on treatment options for symptom management, with many prioritising non-hormonal treatments, including medicinal cannabis and complementary medicine. Others prioritised research on the causes of endometriosis over research on treatments to assist with prevention and eventual cure of the disease. The main drivers for participating in endometriosis research were hope for symptom improvement and a reduction in time to diagnosis. Research design features that were important in supporting participation included ease of access to testing centres (e.g., for blood tests) and sharing test results and automated data collection reminders, with simple stra-tegies to record data measurements. Research incentives for younger people with endometriosis and a broad dissemination of information about research projects was considered likely to increase participant numbers. Barriers included time commitments, a lack of flexibility around research appointments for data collection, travel or work commitments, concerns about the safety of some products, and trying to conceive a child. Conclusions: People with endometriosis were open to participating in research they felt aligned with their needs, with a significant focus on diagnostic tools and symptom relief. However, researchers must co-design approaches to ensure convenience and flexibility for research participation.

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Section: Discussionsupporting

confidence: 87%

Section: Resultsmentioning

confidence: 99%

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Unmet Needs of Australians in Endometriosis Research: A Qualitative Study of Research Priorities, Drivers, and Barriers to Participation in People with Endometriosis

Giese,

Gilbert,

Hawkey

et al. 2023

Medicina

Self Cite

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“…Given the prevalence of gynecological pain, its deleterious effect on quality of life, and the current difficulties in managing this pain, finding effective, safe interventions with low addictive/dependence potential is identified as an international priority [31][32][33].…”

Section: Introductionmentioning

confidence: 99%

The Place of Cannabinoids in the Treatment of Gynecological Pain

Sinclair,

Abbott,

Proudfoot

et al. 2023

Drugs

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Cannabis sativa (L), a plant with an extensive history of medicinal usage across numerous cultures, has received increased attention over recent years for its therapeutic potential for gynecological disorders such as endometriosis, chronic pelvic pain, and primary dysmenorrhea, due at least in part to shortcomings with current management options. Despite this growing interest, cannabis inhabits an unusual position in the modern medical pharmacopoeia, being a legal medicine, legal recreational drug, and an illicit drug, depending on jurisdiction. To date, the majority of studies investigating cannabis use have found that most people are using illicit cannabis, with numerous obstacles to medical cannabis adoption having been identified, including outdated drug-driving laws, workplace drug testing policies, the cost of quality-assured medical cannabis products, a lack of cannabis education for healthcare professionals, and significant and persistent stigma. Although currently lacking robust clinical trial data, a growing evidence base of retrospective data, cohort studies, and surveys does support potential use in gynecological pain conditions, with most evidence focusing on endometriosis. Cannabis consumers report substantial reductions in pelvic pain, as well as common comorbid symptoms such as gastrointestinal disturbances, mood disorders such as anxiety and depression, and poor sleep. Substitution effects were reported, with >50% reduction or cessation in opioid and/or non-opioid analgesics being the most common. However, a substantial minority report not disclosing cannabis consumption to their health professional. Therefore, while such deprescribing trends are potentially beneficial, the importance of medical supervision during this process is paramount given the possibility for withdrawal symptoms.

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“…Due to these issues, novel pain management options are considered an urgent research and clinical priority in endometriosis [36][37][38]. Limited access to surgery often leads to people with endometriosis employing self-management strategies.…”

Section: Introductionmentioning

confidence: 99%

Cannabis and Endometriosis: The Roles of the Gut Microbiota and the Endocannabinoid System

Farooqi,

Bhuyan,

Low

et al. 2023

JCM

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Endometriosis, a chronic condition affecting around 10–14% of women, is challenging to manage, due to its complex pathogenesis and limited treatment options. Research has suggested a potential role of the gut microbiota and the endocannabinoid system in the development and progression of endometriosis. This narrative review aims to explore the role of, and any potential interactions between, the endocannabinoid system (ECS) and the gut microbiota in endometriosis. This review found that both the ECS and microbiota influence endometriosis, with the former regulating inflammation and pain perception and the latter influencing immune responses and hormonal balance. There is evidence that a dysregulation of the endocannabinoid system and the gut microbiota influence endometriosis symptoms and progression via changes in CB1 receptor expression and increased circulating levels of endocannabinoids. Microbial imbalances in the gut, such as increases in Prevotella, have been directly correlated to increased bloating, a common endometriosis symptom, while increases in E. coli have supported the bacterial contamination hypothesis as a potential pathway for endometriosis pathogenesis. These microbial imbalances have been correlated with increases in inflammatory markers such as TNF-α and IL-6, both often raised in those with endometriosis. Protective effects of the ECS on the gut were observed by increases in endocannabinoids, including 2-AG, resulting in decreased inflammation and improved gut permeability. Given these findings, both the ECS and the gut microbiota may be targets for therapeutic interventions for endometriosis; however, clinical studies are required to determine effectiveness.

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Endometriosis research priorities in Australia

Cited by 9 publications

References 23 publications

Unmet Needs of Australians in Endometriosis Research: A Qualitative Study of Research Priorities, Drivers, and Barriers to Participation in People with Endometriosis

Unmet Needs of Australians in Endometriosis Research: A Qualitative Study of Research Priorities, Drivers, and Barriers to Participation in People with Endometriosis

The Place of Cannabinoids in the Treatment of Gynecological Pain

Cannabis and Endometriosis: The Roles of the Gut Microbiota and the Endocannabinoid System

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