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New Study Finds Uncontrollable Stress Worsens Symptoms Of Endometriosis
April 08, 2008SAN DIEGO, CA - Endometriosis is a poorly understood condition that incapacitates and affects the productivity and lifestyle of millions of women around the world. In the US, it affects approximately six million women and adolescents at a cost of some $1.6 billion per year. It is a chronic painful disease which occurs when endometrial tissue grows as lesions outside the uterus, mainly in the area of the ovaries and fallopian tubes, but can also affect the intestinal tract. The condition results in chronic pelvic pain, painful menstrual periods and pain during intercourse.
Many patients report suffering from high levels of stress due to the impact that painful symptoms have on all aspects of their life, including work, family and personal relationships. For example, the physical pain they experience during intercourse can disrupt a healthy sexual relationship, thus causing anguish and discord which leads to further stress.
Circumstantial evidence suggests that a variety of stress management techniques can help women handle stressful situations related to the disease. However, it is not yet known whether stress affects the prevalence or progression of the disease.
A new study investigating the relationship between stress and the painful symptoms of the disease is currently underway. It offers, for the first time, evidence of the negative consequences of stress in the progression of endometriosis, most likely through an effect on the immune system.
Presentation at the 121st Annual Meeting of the American Physiological Society
The study was conducted by an interdisciplinary team of investigators with expertise in endometriosis, animal physiology and behavior. Marielly Cuevas, Olga I. Santiago, Kenira J. Thompson and Caroline B. Appleyard, Department of Physiology and Pharmacology, Ponce School of Medicine, Ponce, Puerto Rico, and Idhaliz Flores of the Department of Microbiology. Dr. Appleyard and her graduate student, Marielly Cuevas, will present the team's findings, entitled The Pathophysiology of Intestinal Endometriosis is Exacerbated by Uncontrollable Stress during the 121st annual meeting of The American Physiological Society (APS; www.the-APS.org/press), part of the Experimental Biology 2008 scientific conference.
The Study
Seven female rats were induced with endometriosis. Of the total, half were subjected to stressful swim tests for ten consecutive days, a chronic and stressful situation the animals could not control. The "endo-stress" group (n=3) was subjected to the swim trials. The "endo-control" rats (n=4) had endometriosis but did not swim. The sham-stress group (n=3) did not have the disease nor did they swim.
Sixty days after the induction of the endometriosis the rats were sacrificed and examined for the presence of endometriotic vesicles (small structures inside cells used to transport liquids such as proteins), and damage to the adjacent organs (including the colon and small intestine). The presence of the enzyme myeloperoxidase (MPO), which is linked to inflammation, was also assayed.
Results
The researchers found that:
* none of the sham-stress animals developed vesicles.
* the endo-control group developed a total vesicle length that averaged 6.57±0.96mm per animal.
* the endo-stress group developed a total vesicle length that averaged 11.26±5.27mm per animal.
* the endo-control rats had higher colonic damage scores than sham-stressed animals, which was increased further by stress.
* the endo-stress rats had the shortest colon length, the highest levels of MPO, the greatest number of colonic mast cells, and an increase in peritoneal fluid immune cell infiltration, all indicative of activation of inflammatory mechanisms.
Conclusion
According to the senior researcher for the study, Dr. Appleyard, "These findings contribute to our understanding of how stress may affect the severity of endometriosis. We think there is likely a connection with the immune system because of the observed levels of mast cells in the colon and the increased levels of inflammatory cells in the peritoneum of the affected rats, since this has also been observed in patients with endometriosis." Appleyard continued, "The results offer a jumping off point to help identify stress-management interventions that will help those women who are affected by the disease."
The American Physiological Society (APS)
A new study investigating the relationship between stress and the painful symptoms of the disease is currently underway. It offers, for the first time, evidence of the negative consequences of stress in the progression of endometriosis, most likely through an effect on the immune system.
Presentation at the 121st Annual Meeting of the American Physiological Society
The study was conducted by an interdisciplinary team of investigators with expertise in endometriosis, animal physiology and behavior. Marielly Cuevas, Olga I. Santiago, Kenira J. Thompson and Caroline B. Appleyard, Department of Physiology and Pharmacology, Ponce School of Medicine, Ponce, Puerto Rico, and Idhaliz Flores of the Department of Microbiology. Dr. Appleyard and her graduate student, Marielly Cuevas, will present the team's findings, entitled The Pathophysiology of Intestinal Endometriosis is Exacerbated by Uncontrollable Stress during the 121st annual meeting of The American Physiological Society (APS; www.the-APS.org/press), part of the Experimental Biology 2008 scientific conference.
The Study
Seven female rats were induced with endometriosis. Of the total, half were subjected to stressful swim tests for ten consecutive days, a chronic and stressful situation the animals could not control. The "endo-stress" group (n=3) was subjected to the swim trials. The "endo-control" rats (n=4) had endometriosis but did not swim. The sham-stress group (n=3) did not have the disease nor did they swim.
Sixty days after the induction of the endometriosis the rats were sacrificed and examined for the presence of endometriotic vesicles (small structures inside cells used to transport liquids such as proteins), and damage to the adjacent organs (including the colon and small intestine). The presence of the enzyme myeloperoxidase (MPO), which is linked to inflammation, was also assayed.
Results
The researchers found that:
* none of the sham-stress animals developed vesicles.
* the endo-control group developed a total vesicle length that averaged 6.57±0.96mm per animal.
* the endo-stress group developed a total vesicle length that averaged 11.26±5.27mm per animal.
* the endo-control rats had higher colonic damage scores than sham-stressed animals, which was increased further by stress.
* the endo-stress rats had the shortest colon length, the highest levels of MPO, the greatest number of colonic mast cells, and an increase in peritoneal fluid immune cell infiltration, all indicative of activation of inflammatory mechanisms.
Conclusion
According to the senior researcher for the study, Dr. Appleyard, "These findings contribute to our understanding of how stress may affect the severity of endometriosis. We think there is likely a connection with the immune system because of the observed levels of mast cells in the colon and the increased levels of inflammatory cells in the peritoneum of the affected rats, since this has also been observed in patients with endometriosis." Appleyard continued, "The results offer a jumping off point to help identify stress-management interventions that will help those women who are affected by the disease."
The American Physiological Society (APS)
Endometriosis Current Events and Endometriosis News RSSAt last -- a quick and accurate way of diagnosing endometriosis
A quick and accurate test for endometriosis that does not require surgery has been developed by researchers from Australia, Jordan and Belgium, according to new research published online today (Wednesday 19 August) in Europe's leading reproductive medicine journal Human Reproduction.
Uterine cells produce their own estrogen during pregnancy
For decades, scientists assumed that the ovary alone produced steroid hormones during pregnancy.
MRI accurately depicts deep endometriosis
Using magnetic resonance imaging (MRI), radiologists may be able to diagnose deep endometriosis and accurately locate lesions prior to surgery, according to a new study published in the online edition of Radiology.
Study identifies how tamoxifen stimulates uterine cell growth and cancer
UCSF researchers have identified a new "feed-forward" pathway linking estrogen receptors in the membrane of the uterus to a process that increases local estrogen levels and promotes cell growth.
Women with endometriosis need special care during pregnancy to avoid risk of premature birth
The largest study to date of endometriosis in pregnant women has found that the condition is a major risk factor for premature birth.
Progress made in understanding causes and treatment of endometriosis
Endometriosis is a poorly understood chronic disease characterized by infertility and chronic pelvic pain during intercourse. It affects between 5 to 10 million women in the U.S.
UC Davis researchers find decrease in hysterectomy complications
UC Davis researchers who studied hospital discharge records for nearly 650,000 California women over a 13-year period have found that complications from hysterectomies have significantly declined.
Scientists identify possible cause of endometriosis
Endometriosis is a condition whereby patches of the inner lining of the womb appear in parts of the body other than the womb cavity. It can cause severe pain and affects approximately 15% of women of reproductive age. Endometriosis is also associated with infertility, with 50% of infertile women affected by the condition.
Treatment advances for fibroids, menopause
Women with fibroids and endometriosis facing the possibility of hysterectomy may now choose less invasive treatment options to preserve fertility, according to Yale professor Aydin Arici, M.D., who will direct a scientific session exploring these alternatives at the American College of Obstetricians and Gynecologists (ACOG) Annual Clinical Meeting May 3-7 in New Orleans, Louisiana.
May inflammatory bowel disease mimic gynecological disorders in its clinical presentation
Endometriosis is a condition of unknown etiology in which endometrial tissue occurs at extra-uterine sites, including ovaries, fallopian tubes, and gastrointestinal tract.
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