Endometriosis, challenges and diagnosis

While SENSOPAD is not a treatment for endometriosis, it aims to bridge this critical gap by offering a faster, non-invasive, and more accessible approach to diagnosis and monitoring. The project is developing an innovative wearable sensor embedded in a sanitary pad (sensoPAD) and a clinical DNA analysis device (SensoMFgFET) to detect key biomarkers associated with the disease. Combined with a mobile application for real-time data access and communication with healthcare professionals, SENSOPAD has the potential to transform how endometriosis is diagnosed, significantly reducing diagnostic delays and enabling earlier, more effective clinical interventions.

Endometriosis is a chronic and often painful condition where tissue similar to the lining of the uterus grows outside the uterus, typically affecting the ovaries, fallopian tubes, and pelvic tissues. This ectopic tissue can lead to significant symptoms, including severe menstrual pain, pain during intercourse, and infertility, affecting approximately 10% of women of reproductive age in Europe (European Society of Human Reproduction and Embryology [ESHRE], 2020).

The challenges of endometriosis include delayed diagnosis, with many women experiencing an average wait time of 7 to 10 years due to the condition’s variable symptoms and misdiagnosis as other disorders (Sims et al., 2021). Additionally, the complexity of treatment options, which may include hormonal therapies, pain management, or surgery, can lead to ongoing physical and emotional distress for patients, significantly impacting their quality of life (Culley et al., 2013).

Endometriosis is diagnosed through a combination of medical history, physical examinations, imaging techniques such as ultrasound or MRI, and the definitive method of laparoscopic surgery. During laparoscopy, healthcare providers can directly visualize endometrial-like tissue and perform biopsies if necessary, allowing for accurate diagnosis and potential treatment (Pascoal et al., 2022).

Menstrual fluid (MF)/menses is a rich yet underexplored biological sample that offers a non-invasive alternative to endometrial biopsies. Unlike conventional methods, which require surgical intervention, MF naturally contains endometrial tissue, immune cells, and molecular biomarkers reflective of the uterine environment. Recent studies have demonstrated its potential in identifying key inflammatory markers, hormonal imbalances, and genetic variations associated with endometriosis and other gynecological disorders.

By analysing MF, researchers can gain deeper insights into the pathophysiology of endometriosis, improving early diagnosis and disease monitoring. However, standardisation of MF collection, storage, and processing remains a challenge, which SENSOPAD will try to address

• Culley L, Law C, Hudson N, Denny E, Mitchell H, Baumgarten M, Raine-Fenning N. The social and psychological impact of endometriosis on women’s lives: a critical narrative review. Hum Reprod Update. 2013 Nov-Dec;19(6):625-39. doi: 10.1093/humupd/dmt027. Epub 2013 Jul 24. PMID: 23884896.

• ESHRE. (2020). “Endometriosis: The ESHRE Guideline.” European Society of Human Reproduction and Embryology. Retrieved from ESHRE Website.

• Sims, O. T., Gupta, J., Missmer, S. A., & Aninye, I. O. (2021). Stigma and endometriosis: a brief overview and recommendations to improve psychosocial well-being and diagnostic delay. International journal of environmental research and public health, 18(15), 8210.

• Pascoal, E., Wessels, J. M., Aas‐Eng, M. K., Abrao, M. S., Condous, G., Jurkovic, D., … & Leonardi, M. (2022). Strengths and limitations of diagnostic tools for endometriosis and relevance in diagnostic test accuracy research. Ultrasound in Obstetrics & Gynecology, 60(3), 309-327.