Endometriosis future or investigational therapies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Joseph Nasr, M.D.[2]

Overview

Although no curative therapy currently exists, ongoing research focuses on improved diagnostic tools, biomarker development, and subtype-specific management strategies.

Future and Investigational Directions

  • Novel blood-based biomarkers are under investigation to improve detection and monitoring of endometriosis; however, no diagnostic blood or molecular markers have been validated in clinical populations.[1]
  • Advances in imaging include augmented pelvic ultrasound and endometriosis-specific magnetic resonance imaging protocols to improve detection of deep and extrapelvic disease.[2][3]
  • Emerging research emphasizes the role of central sensitization and nociplastic pain mechanisms, which may influence future multimodal treatment approaches.[4][5]
  • Recognition of endometriosis subtype heterogeneity (superficial, ovarian, deep) supports development of more individualized and precision-based therapeutic strategies.[6][7]

References

  1. Gibbons T, Rahmioglu N, Zondervan KT, Becker CM. Crimson clues: advancing endometriosis detection and management with novel blood biomarkers. Fertil Steril. 2024;121(2): 145-163. doi:10.1016/j.fertnstert.2023.12.018
  2. Young SW, Jha P, Chamié L, et al. Society of Radiologists in Ultrasound consensus on routine pelvic US for endometriosis. Radiology. 2024;311(1): e232191. doi:10.1148/radiol.232191
  3. Avery JC, Knox S, Deslandes A, et al; Imagendo Study Group. Noninvasive diagnostic imaging for endometriosis, 2: a systematic review of recent developments in magnetic resonance imaging, nuclear medicine and computed tomography. Fertil Steril. 2024;121(2):189-211. doi:10.1016/j.fertnstert. 2023.12.017
  4. Coxon L, Demetriou L, Vincent K. Current developments in endometriosis-associated pain. Cell Rep Med. 2024;5(10):101769. doi:10.1016/j. xcrm.2024.101769
  5. Kaplan CM, Kelleher E, Irani A, Schrepf A, Clauw DJ, Harte SE. Deciphering nociplastic pain: clinical features, risk factors and potential mechanisms. Nat Rev Neurol. 2024;20(6):347-363. doi:10.1038/s41582-024-00966-8
  6. Horne AW, Missmer SA. Pathophysiology, diagnosis, and management of endometriosis. BMJ. 2022;379:e070750. doi:10.1136/bmj-2022-070750
  7. Becker CM, Bokor A, Heikinheimo O, et al; ESHRE Endometriosis Guideline Group. ESHRE guideline: endometriosis. Hum Reprod Open. 2022; 2022(2):hoac009. doi:10.1093/hropen/hoac009