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Endometriosis

Endometriosis: A new urine test could reduce diagnosis times by years

Endometriosis can cause long lasting pain, fatigue and fertility problems. Yet despite 1 in 10 women having endometriosis it still takes an average of eight years from the first symptoms to get a diagnosis. But now, scientists are developing a new, non-invasive test that could significantly reduce the diagnosis time.

Endometriosis is where cells that are similar to the ones in the lining of the womb (uterus) are found elsewhere in the body. Each month, these cells react in the same way as the ones in the womb - they build up, then break down and bleed.

But while the blood in the cells in the womb leaves the body when you have your period, there’s nowhere for this blood to go - which causes inflammation, pain and the formation of scar tissue. If untreated, depending on where this tissue is, it can lead to organ damage and infertility.

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How endometriosis could be diagnosed with a simple urine test

Currently, women may need multiple appointments with specialists, as well as ultrasound and MRI scans, to determine whether they have endometriosis. To be definitely diagnosed they may also need a surgical procedure called a laparoscopy - when a surgeon cuts into the abdomen to look for endometriosis tissue. But, University of Hull researchers are developing a new urine sample test to give a rapid, non-invasive test to help detect the condition.

Dr Barbara Guinn, biomedical sciences specialist at the University of Hull, identified proteins that are increased in the urine of women suffering from endometriosis.

It is not available for the public yet, but it is this discovery that will enable the development of the test, called EndoTect, that will take seconds to indicate whether endometriosis is the cause of the symptoms a patient is experiencing.

“If you think you may have endometriosis because you have intermenstrual bleeding ,bleeding between periods, and feel pain when you have periods, sex, or go to the bathroom or if you have been trying to get pregnant, for a long time - will be able to go to your family doctor and discuss the issues you are facing,” she explains.

“If your doctor suspects deep endometriosis, you may be asked to provide a urine sample, which can be sent to the lab and tested.” she says. “The results could be back within 8 to 14 days.”

The test can also indicate whether patients have deep or superficial endometriosis and monitor the effectiveness of treatment. As is the case with many diseases, endometriosis can vary in severity.

With deep endometriosis, which is more severe and advanced, the endometriosis cells can embed themselves deeper into the tissues. Because they’re closer to organs like the bowels and bladder, as well as the nerves and blood vessels, they can be more difficult to remove surgically. Often, deep endometriosis can cause more severe symptoms too.

However, identifying how severe the disease is, is the first step in finding the right treatment. “The test will mean people get treatment quickly,” says Guinn. “The sooner we treat endometriosis, the less difficult it will be to treat and the more effective the treatment. It will also end the current average eight year wait patients seeking answers face.”

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Endometriosis

The endometrium is the tissue that lines the inside of the womb (uterus). Endometriosis is a condition where tissue similar to endometrial tissue is found outside the uterus, in the pelvic area and lower tummy (abdomen) and, rarely, in other areas in the body. Currently it is not known what causes endometriosis. There are many responsible factors, possibly including genetic, immunological and hormonal reasons. Endometriosis only affects those who are of the female sex, therefore the words woman/women and the pronouns she/her will be used throughout this leaflet. Some patients with endometriosis will have a gender identity which differs from their biological sex - healthcare professionals should respect their gender identity and choice of pronouns. Endometriosis in trans men is discussed at the end of the leaflet.

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Affect of endometriosis

It’s a condition with no cure that causes suffering for the 1.5 million women - and those assigned female at birth - affected. Being diagnosed is essential to access treatments to ease the symptoms, but this can take a long time because the symptoms vary widely and may be dismissed as ‘just period pain’.

Guinn says that endometriosis presents in a similar way to other gynaecological disorders such as pelvic inflammatory disease or ovarian cysts, which can make a diagnosis difficult.

It’s important to take into account the psychological impact of endometriosis too. The pain, as well as problems with fertility, can cause emotional trauma, relationship difficulties and even affect people’s careers and social lives too. Endometriosis costs the UK economy £8.2bn a year in treatment, loss of work and healthcare costs1.

Although the test is still being developed, it’s hoped it will be available to the public in a few years.

“We hope the test will first be used by healthcare professionals who can talk to patients about the results and give them advice and a chance to ask any questions they may have,” says Guinn. “EndoTect, our non-invasive urine test for endometriosis is still in the early stages of development and so may take another 2 to 3 years before it is available, hopefully through the NHS.”

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Further reading

  1. Endometriosis UK: Facts and figures.

Article history

The information on this page is peer reviewed by qualified clinicians.

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