Trial aims to help cool endometriosis pain

Breath work, meditation and cold-water immersion therapy are at the centre of a University of Adelaide trial which is now underway and seeking participants.

The EndoChill study, led by the Neuroimmunopharmacology Laboratory Head Professor Mark Hutchinson, is exploring the use of breathing, exercise and cold water therapy for the treatment of endometriosis pain.

Endometriosis, where tissue similar to the lining of the uterus grows outside the womb, affects about 14 per cent of women and individuals assigned female at birth.

The chronic inflammatory condition can cause symptoms including period pain, pelvic pain, infertility and fatigue.

Participants will record the details of their pelvic pain and endometriosis symptoms daily, have an ultrasound to measure endometriosis lesions and a blood test to measure inflammation before starting the study, as well as completing a set of surveys on their overall wellbeing.

They will also participate in a three-hour training workshop to learn breathing, meditation and cold-water immersion techniques before being encouraged to perform the exercises at home as often as they want.

Trial participants will record their pain, symptoms and use of the method for 12 weeks, with repeat blood tests and surveys at the halfway and final stages of the intervention phase.

Co-researcher Dr Kelsi Dodds, who was appointed a 2023-24 Superstar of STEM by Science and Technology Australia and joined the University last year, said a second ultrasound, blood test and survey were required after the end of an eight-week follow-up phase.

“As most of the trial can be done at home, it provides accessibility and opportunity for a group of people who may experience heavy pain days and associated issues which would otherwise make it challenging to attend regularly,” said Dr Dodds.

“We will have supervised cold-water immersions twice a week for those who want to attend, but at most, people will only have to see us about six times over a six-month period.

“We know current interventions for people with endometriosis, largely have suboptimal impacts on symptoms and can be associated with unchanged or worsening pain.

“Consequently, people with endometriosis frequently seek alternative treatment options to manage their symptoms.”

Millie Mardon first experienced endometriosis symptoms at aged 12 and received her formal diagnosis at 14.

“My main symptoms were bad period and pelvic pain, frequent bleeding (approximately every two weeks), heavy bleeding, fatigue, and headaches,” said Dr Mardon, who also completed her PhD in pelvic pain and endometriosis last year.

“These had such an impact on my quality of life because it meant a lot of time off school, not being able to socialise with friends, and play sport – things that all normal teenagers want to be doing.

“In endometriosis years that is relatively short compared to the average time to diagnosis, which is about six to eight years after symptoms start.”

Because there’s no one-size-fits-all treatment, Dr Mardon struggled with pain management for about five years, trying different hormonal therapies to suppress her menstrual cycle.

“I had my first laparoscopy to remove endometriosis lesions but unfortunately that didn’t do much to control my pain,” she said.

“It wasn’t until I was 17 when I had my second laparoscopy, combined with pelvic physiotherapy, gentle exercises and the right medications for me that I started managing my pain well; I’ve been relatively pain free since then.”

Dr Mardon said she was encouraged by the EndoChill trial, because the more treatment options that were available, the better.

“If deemed effective, the EndoChill trial will have big benefits on the endometriosis community because it provides evidence for an intervention - meditation and cold-water immersion - that is relatively low-cost and easily accessible,” she said.

“While symptom management is important, this trial is also looking at biochemical markers to understand how this intervention changes our biology and physiology.

“This is something that isn’t looked into enough in the endometriosis space, so uncovering some of this information and data will be really insightful.

“Studies such as these can have massive benefits to the endometriosis community, but we need people’s help to make it happen.”

Professor Louise Hull is the founder and leader of the Endometriosis Group at the University of Adelaide’s Robinson Research Institute which is working on ways to better diagnose the condition.

“It is exciting to see work happening in the intervention space because an endometriosis diagnosis is just one piece of the puzzle,” said Professor Hull.

“In this study, it’s essentially giving people three different ways to manage and control their pain – through breathing, cold water immersion and exercise.”

The trial which has been made possible by a grant from the Wilson Foundation.

For more information or to register, visit https://adelaideuniwide.qualtrics.com/jfe/form/SV_4GDjVsPAgMdaTJA