Review summarizes metabolomic advances in endometriosis research

Endometriosis is a disease that affects up to one in ten women of reproductive age and it remains a painful disorder that often leads to infertility. Despite major research efforts, its exact mechanisms are still unclear, and diagnosis usually requires invasive surgery.

A review article published in Reproductive and Developmental Medicine by researchers from Fudan University (Shanghai, China) and the Shanghai University of Traditional Chinese Medicine summarizes recent progress in understanding how changes in metabolism may reveal new ways to diagnose and treat this disease.

The review integrates findings from dozens of metabolomics studies analyzing blood, endometrial tissue, and body fluids such as follicular and peritoneal fluid from women with endometriosis. The authors highlight that the disease triggers widespread disruptions in lipid, amino acid, and energy metabolism, alterations that may serve as potential diagnostic markers and therapeutic targets.

“Metabolomics allows us to see the biochemical fingerprints of endometriosis,” the authors wrote. “By mapping these changes, we can better understand the disease process and identify new noninvasive biomarkers.”

Key patterns identified across studies include increased oxidative stress, altered lipid metabolism, and enhanced glycolysis. Elevated lactate and reduced glucose levels, for instance, reflect abnormal cellular respiration and may promote inflammation and lesion growth. Changes in specific lipids, such as sphingolipids and phosphatidylcholines, appear to contribute to pain and infertility.

The review also summarizes evidence from follicular and peritoneal fluid studies, showing that metabolic imbalance and oxidative stress can impair oocyte quality and fertility outcomes. Some compounds, including amino acids like alanine and valine, and antioxidants such as vitamins C and E, may help indicate disease stage or treatment response.

While metabolomics has already uncovered promising diagnostic leads, the authors emphasize that more standardized and large-scale studies are needed before these biomarkers can be used clinically. They also point to emerging therapeutic avenues: antioxidant supplements (e.g., vitamin E, N-acetylcysteine) and metabolism-modifying drugs such as statins may help reduce inflammation, oxidative stress, and pain in endometriosis.