Could we finally see a pill to treat endometriosis pain?

Could this finally be a breakthrough for the treatment of endometriosis pain? Doctors are trialling a ground-breaking new pill which they hope will pave the way for a new drug. The trial will involve 100 women in Edinburgh and London and will assess whether the drug, dichloroacetate, helps relieve pain. If successful, it would be the first non-hormonal, non-surgical treatment for endometriosis, which roughly affects one in 10 women of reproductive age. 

Dr Lucy Whitaker, the doctor leading the trial says “Our research so far shows promising results that dichloroacetate can make a huge difference. I hope our new trial will confirm this and give women hope that new treatments and a better quality of life are on the horizon”.

Janet Lindsay, the chief executive of Wellbeing of Women, a women’s health charity that is funding the trial with the Scottish government, said that progress in treating endometriosis was “long overdue”.

Women in the UK typically wait around eight years for a diagnosis and suffer four different stages of endometriosis with stage four being the most painful. It often leads to problems with fertility, and women have been encouraged to freeze their eggs to give them better chances of conceiving in their thirties.

Our endometriosis reporter Emma Kemsley who has stage four endometriosis, was told by doctors she should try for a baby in her twenties because time wasn’t on her side. But she ignored them and has lived to regret it after going through seven rounds of IVF in her thirties.

She remembers the pain escalating in her twenties and being bed ridden because of it, biting on her metal bed frame out of sheer agony. She says: “I would go to see my doctor every month and all he would prescribe is ordinary pain killers which didn’t work. I welcome this new drug trial and really hope and pray it works”.

Previous research revealed that cells from the pelvic wall of women with endometriosis produce higher amounts of lactate, a potentially harmful waste product that is normally produced by muscles and red blood cells when the body is running low on oxygen during exercise. In endometriosis, lab-based experiments suggested the lactate was creating an environment that fuelled the development and growth of endometrial tissue in the body.

When cells were treated with dichloroacetate, in the lab and in mouse experiments, lactate production decreased to normal levels and the size of the endometriosis lesions was reduced. The drug has already been used as a medicine to treat rare childhood metabolic disorders and various cancers, meaning that it has an established safety profile.

In a pilot study, with 30 women, the main side-effects were a slightly upset stomach on starting the medication and a tingling sensation in the fingers.

In the latest trial, which will start recruiting this autumn, half of the women will receive dichloroacetate and half will be given a placebo and they will take the tablets for 12 weeks. The participants will complete a series of questionnaires and give blood samples over the course of two-and-a-half years, to determine whether the treatment is effective for relieving pain and other symptoms.