Helping women with endometriosis reduce stress could improve their disease, a study in rats suggests.
A more stimulating environment reduced the animals’ anxiety, leading to a milder disease, compared with rats in non-stress-filled conditions.
Researchers at the Ponce Health Sciences University in Puerto Rico conducted the study, which they titled “Environmental Manipulations as an Effective Alternative Treatment to Reduce Endometriosis Progression,” It appeared in the journal Reproductive Sciences.
The team noted that current treatment approaches — surgery and drugs — have a limited long-term impact on endometriosis and a number of side effects.
Meanwhile, studies have suggested that many women with endometriosis have ramped-up levels of stress hormone signaling. This means they need a broader treatment approach than one that focuses mainly on reducing endometriosis cysts, the researchers said.
Previous studies had demonstrated that reducing stress could slow the progression of endometriosis. But the research did not shed light on how this happened.
The Puerto Rican team created a more stimulating environment for a group of rats to see if it would reduce their anxiety. It included larger cages to facilitate movement and exploration, and more contacts with other rats. In contrast with the more stimulating environment, a control group of rats was raised in standard conditions.
Researchers introduced endometriosis to half the rats in each group, using the other half as controls.
There was no difference in the anxiety levels of the rats with endometriosis and without it at the beginning of the study. But those with endometriosis that were raised in an enriched environment had lower anxiety levels at the end of the study.
A key finding was that the diseased rats that were raised in the stimulating environment had 28 percent fewer endometriosis cysts than the endometriosis rats bred in standard conditions. In addition, the cysts of the rats raised in the stimulating conditions were smaller than those in the rats reared in standard conditions.
Researchers also discovered that rats with endometriosis, regardless of their living conditions, had smaller adrenal glands — the organ that generates the stress hormone cortisol — and produced less of the hormone than the control rats.
While an enriched environment had no impact on cortisol levels, it reduced the activity of the gene that generates corticotropin-releasing hormone, which drives cortisol production.
Another finding was that the more stimulating environment reduced the activity of the glucocorticoid receptor that cortisol binds to. Evidence indicated that an enriched environment activates the receptor in a different way than a standard environment, researchers said.
The findings demonstrated that reducing anxiety affected the biological pathways that control stress. The implication was that reducing the stress of women with endometriosis could lead to less disease activity with a minimal risk of side effects.