Hope for women who suffer infertility, pelvic pain during sex

January 20th, 2009 - 12:56 pm ICT by IANS  

Washington, Jan 20 (IANS) There is some hope for women who suffer from endometriosis, infertility and pelvic pain during sex, a chronic disease that affects five to 10 million women in the US. Serdar Bulun, professor of gynaecology at Northwestern University’s Feinberg School of Medicine and colleagues have discovered key epigenetic abnormalities in endometriosis and identified existing chemicals that now help treat it.

Epigenetics is the study of the processes involved in the genetic development of an organism, especially the activation and deactivation of genes.

One of the abnormalities is the presence of enzyme aromatase - which produces oestrogen - in endometriosis, the diseased tissue that exists on pelvic organs and mimics the uterine lining. Normal endometrium, located in the uterine cavity, does not contain aromatase.

Consequently, women with endometriosis have excessive oestrogen in this abnormal tissue found on surfaces of pelvic organs such as the ovaries.

Bulun found the protein SF1 that produces aromatase, which is supposed to be shut down, is active in endometriosis.

“Oestrogen is like fuel for fire in endometriosis,” Bulun said. “It triggers the endometriosis and makes it grow fast.”

As a result of the aromatase finding, Bulun launched clinical trials in 2004 and 2005 testing aromatase inhibitors - currently used in breast cancer treatment - for women with endometriosis.

The drug blocks oestrogen formation and secondarily improves progesterone responsiveness. “We came up with a new treatment of choice for post-menopausal women with endometriosis,” Bulun said.

Moreover, treatment with an aromatase inhibitor is a very good option for premenopausal women with endometriosis not responding to existing treatments, he noted.

Bulun believes that these abnormalities result from epigenetic defects that occur very early on during embryonic development and may be the result of early exposure to environmental toxins, said a Northwestern release.

These findings were published in the January issue of the New England Journal of Medicine.

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