The launching of the National Action Plan for Endometriosis in Australia, 2018, put the spotlight on a debilitating disease estimated to affect 5-10% of reproductive-aged women, or approximately 176 million women worldwide. The disease is characterised by the presence of endometrial-like tissues in ectopic locations, usually within the pelvic cavity. Individuals present with diverse symptoms, particularly fertility issues, severe menstrual pain and chronic pelvic pain, with resultant impacts on the physical, psychological and social wellbeing of affected individuals and their whānau. Recognising the heterogeneity of disease experience, we are currently exploring the needs and wants expressed by women with endometriosis. Our aim is to develop tools that assist clinicians and researchers to improve the quality of life of those with endometriosis.
In addition to the variability in symptom presentation, there is also considerable heterogeneity in the nature and extent of endometriotic lesions. Using multiple approaches, we are aiming to provide detailed phenotypic information about these lesions. This includes the characterisation of standard pathology-based lesion biopsies stained with haematoxylin and eosin and dual immunostaining to outline inter-and intra-patient variability across a range of cell and tissue characteristics. Further, we are employing cutting-edge Fourier-transform infrared spectroscopy (FT-IR) and mass-spectrometry imaging to characterise patterns of metabolites and proteins in endometriotic lesions. While still preliminary, we hope these studies will contribute to our understanding of disease aetiology by linking phenotype to the diverse genetic and expression quantitative trait loci (eQTL) data already available. Ultimately, our ongoing studies are aimed at enhancing our understanding of pathophysiology, identifying diagnostics and improving therapeutic options for those with endometriosis.