Endometriosis: how to reduce diagnostic delays and symptoms?
Dernière mise à jour : 3 janv.
With 10% prevalence and chronic effects, endometriosis is one of the most impactful diseases on reproductive age women. FemTech start-ups and biopharmas aim at reducing diagnostic delays and symptoms. Medical research and public policies will play a crucial role to further understand this condition.
A note to conscientious readers:
While I use the term “women” in this article for simplicity, I refer to all individuals with uterus and ovaries, including some transgender men, non-binary people, intersex people or people with variations in sex characteristics.
Additionally, I will highlight innovative solutions that aim at diagnosing endometriosis and decreasing associated symptoms. Should you need more information on these options (for instance, indications for use), please refer to the web links. This article shall not be interpreted in any manner as a medical prescription or medical advertising.
An old disease…
Affecting 190 million women worldwide, endometriosis was discovered 300 years ago.
If the endometriosis population was a country, it would be the 8th largest country in the world after Nigeria. This disease affects roughly 10% (190 million) of reproductive age women and girls globally.
According to the NHS (UK), endometriosis is a chronic condition where tissue similar to the lining of the womb starts to grow in other places, such as the ovaries and fallopian tubes. The disease was first described around 1690.
Affecting women of any age, its causes remain unknown. Several origin theories have been suggested, including genetics, retrograde menstruation or problems with the immune system.
… that remains problematic
Debilitating symptoms, diagnostic delays and limited treatments make it a painful condition to live with.
Endometriosis is a problematic disease for several reasons:
First, its symptoms can be life-impacting.
Most prevalent ones include severe pain during periods, sexual intercourse, bowel movements and/or urination, chronic pelvic pain, fatigue, and sometimes depression.
“Pain during sexual intercourse is the n°3 most prevalent symptom of endometriosis. Extremely taboo, patients don’t dare to discuss it with their healthcare providers and relatives. I was one of the first authors worldwide to write on this topic and highlight concrete solutions” explained to us Marie-Rose Galès, endometriosis patient expert and author of 3 books on endometriosis.
Additionally, this disease is also correlated with infertility as recent data suggest that up to 50% of women with infertility may suffer from this condition.
Second, with an average diagnostic delay of 6.7 years, this condition is often underdiagnosed or misdiagnosed, delaying access to early treatments.
This can be explained by i) the various forms of endometriosis, making it complex to identify, ii) limited knowledge among healthcare professionals and the society in general and iii) the intrusiveness of diagnosis methods.
“At age 26, I spent 6 months going from doctor to doctor not knowing what this chronic pain was. No one could help me and the best source of information I had was Google at the time" remembered Marie-Rose Galès. "My diagnosis journey was so long and complex that I decided to write books with accumulated knowledge to facilitate the experience of young girls and women in the same situation”.
Third, there is currently no cure for endometriosis, only treatments that aim at easing symptoms. They may include painkillers, hormone medicines and contraceptives and / or surgeries to cut away patches of endometriosis tissues or remove parts of the organs affected.
As she was looking for therapeutics, Marie-Rose wrote a full book on available solutions abroad that she now uses to evangelize healthcare providers and patients in France.
Hopefully, this estrogen-dependent inflammatory disease is said to decrease during menopause.
How to improve diagnosis and treatments?
New ways to diagnose endometriosis and reduce pain emerge.
When scanning 16 companies worldwide, including 10 in France, we discovered 3 types of innovations: i) at-home diagnostic tests, ii) treatments and iii) digital solutions.
i) At-home diagnostic tests
How to decrease the average diagnostic delay of 6.7 years?
Different solutions are investigated:
First, the NHS (UK) recommends tracking menstrual cycles and their symptoms (length, abundance, pain…) and showing them to general practitioners (GPs) so that they can assess their “normality”. GPs can then prescribe additional exams if an endometriosis is suspected.
With their millions of users of which 10% might suffer from endometriosis, these apps could leverage machine learning to predict the risk levels of developing such a chronic disease. Clue stated in 2019 that it was looking to predict the risk of polycystic ovarian syndrome (PCOS). Could endometriosis be next?
Second, answering medically-validated questionnaires may facilitate early diagnosis as is the case with Luna start-up in France. Their LUNAEndoScore algorithm is a CE-certified medical device that calculates a risk score identifying the probability of having endometriosis with a sensitivity of 84% and a specificity of 94%.
Third, non-invasive at-home tests leveraging different biomarkers present potential as well. While Endodiag (France), DotLab and NextGen Jane (US) conduct clinical research on blood tests, Ziwig Endotest (France) will require a saliva sample.
When looking at the biopharma scene, several companies are investigating therapeutic treatments to ease endometriosis pain:
Gynica is developing cannabis-based therapeutics
Womed is focusing on intrauterine drug delivery
Other start-ups focus on natural solutions.
Among them, 2 French companies caught our attention:
The Lab de l’Endo is an online concept store with varied products to ease endometriosis symptoms, including herbal infusions.
iii) Digital companions
For patients diagnosed with endometriosis, 7 start-ups develop digital solutions to support their daily journey. Most of them provide either education content, coaching programs including symptom tracking and / or telemedicine services.
The development of digital therapeutics (DTx) with proven clinical benefits and coverage possibilities could be next on the market.
Endometriosis definitely needs to become a public health priority to change the life of millions of reproductive age women worldwide.
Medical research funding will be critical to discover efficient therapeutics.
More disease awareness among patients and healthcare professionals will also be an important step, as Marie-Rose highlighted.
Thanks for reading this article.
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Charlotte Puechmaille from FemTech Now
This article was initially published on the FemTech Now Linkedin page on April 25, 2022.