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Endometriosis Research Study Newsletter  |  Spring 2014

Juneau Biosciences, LLC  |  2749 E. Parleys Way, Suite 210  |  Salt Lake City, UT  84109 

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    GENE-ius Diaries

Dear Diary,

If endometriosis causes infertility, why hasn’t endometriosis just gone away over time?

No one knows the complete answer, but there are several clear factors that keep endometriosis around.  One is timing. Endometriosis is a progressive disease. In most women it grows over time, starting at puberty. You may have very painful periods from the get-go, but most women won’t have a lot of endometriosis and scarring develop during the first few years that they are fertile. Some women start having babies before the endometriosis gets bad enough to interfere with fertility.

This was ESPECIALLY true once-upon-a-time. For most of human history, girls probably had only a few periods before they got pregnant, then they breast fed and got pregnant again. Pregnancy suppresses endometriosis. Breast-feeding suppresses estrogen, so that also inhibits endometriosis. Thus, the genetic tendency for endometriosis got passed on before the endometriosis could prevent women from having children.

Now women are having babies, on average, when they’re older. In the 1960’s, women aged 20 to 24 had the highest birth rates. The CDC (United States Centers for Disease Control and Prevention) reports that birth rates are now more spread out across women’s reproductive years. The most babies are born to women aged 25-29; almost as many to women aged 30-34; and just a little fewer to women aged 20-24. This probably allows endometriosis to cause more infertility problems, making early diagnosis all the more important, so disease progression can be minimized.

The other huge factor that allows endometriosis to persist, we’ll call “complexity.” The symptoms vary a lot. A woman may have a bunch of endometriosis without experiencing pain or difficulty getting pregnant. But her daughter could get endometriosis that causes pain or trouble conceiving. It is also clear that there are different types of endometriosis, which scientists will one day be better able to define and classify. For example, some endometriosis stays superficial, some invades deeply, and some causes ovarian cysts. Having pain or infertility or no symptoms at all – is this caused by different types of endometriosis? We don’t know. And complicating all this, the genetic kicker is that there are several different combinations of genes and outside factors that lead to endometriosis…but we don’t yet understand them. 

Thanks to all of Juneau Biosciences’ supporters and study participants, we’re making progress. Our research findings are only baby steps in the big picture of the genetics of endometriosis, but that’s how you learn to walk, starting with baby steps!

Til next time-