Spotlight on Clinical Research: Endometriosis
Endometriosis affects about 10 percent of reproductive-age women. It occurs when tissue that normally lines the uterus (endometrial tissue) grows elsewhere in the body, such as on the ovaries, fallopian tubes, or in the abdominal cavity. Endometriosis can cause painful menstrual cramps, pelvic pain and infertility. Sometimes it doesn’t cause any symptoms and is diagnosed when a woman is trying to conceive.
One of the problems with treating endometriosis is that it can be resistant to commonly used therapies. The standard treatment is oral contraceptives, which prevent overgrowth of endometrial tissue. If the endometriosis becomes unresponsive to this treatment, women must turn to a medication called Lupron, which stops the ovaries from producing estrogen. But sometimes the endometriosis produces its own estrogen, which limits the effectiveness of Lupron.
“Endometriosis can be resourceful in getting around our therapies,” said Dr. Hugh Taylor, chief of obstetrics and gynecology at Yale-New Haven Hospital. “It’s actively growing every month and can cause inflammation and scarring.”
Along with other physicians, Dr. Taylor is interested in finding alternative ways of blocking estrogen production in order to treat endometriosis. One exciting new therapy is a medication known as an aromatase inhibitor. Used to treat breast cancer, it works by blocking the enzyme that makes estrogen. “To use an enzyme inhibitor to halt estrogen production by a different mechanism is a great idea to stop the growth of these lesions,” said Dr. Taylor. “They depend on estrogen for their growth and if we can block that they won’t survive.”
Later this spring, as part of a multi-center clinical trial, Dr. Taylor will test a new product that delivers an aromatase inhibitor by way of a vaginal ring. The idea is that administering the medication locally where it’s needed will cut down on the side effects such as hot flashes and vaginal dryness that normally occur due to lack of estrogen.
Women who have undergone surgery showing that they have endometriosis and are willing to use the study medication may be eligible to participate in the trial.
Unfortunately, many women suffer for years from endometriosis before it’s diagnosed and treated. “Maybe if we found it earlier we could treat it medically before it caused scarring,” said Dr. Taylor. He is developing a new blood test that might allow earlier detection of endometriosis by measuring biomarkers in the blood. He is also studying the causes of endometriosis and translating basic findings in the laboratory that may be tested in future clinical trials.
“Unless we have rigorously conducted clinical trials, these drugs or potential tests for endometriosis and other diseases will never help improve people’s lives,” said Dr. Taylor.
If you are interested in the latest treatments for endometriosis, including clinical trials for which you may be eligible, you can make an appointment with Dr. Taylor at the Yale Fertility Center by calling 203-785-4708.