Resident leads multi-centre, cross-sectional study on iron deficiency in endometriosis

Endometriosis is a complex and often debilitating disease, affecting more than 176 million girls, women, and unmeasured numbers of transgender, nonbinary and gender diverse people worldwide, according to The Endometriosis Network Canada (TENC). In honour of Endometriosis Awareness Month, the Department of Obstetrics and Gynaecology is showcasing a resident-led multi-centre research study on endometriosis and iron deficiency.

Iron deficiency (ID) and iron deficiency anemia (IDA) contribute to a significant disease burden worldwide. In Canada, 9% of women aged 20-49 years are iron deficient. ID and IDA symptoms include fatigue, weakness, dizziness, irritability, decreased stamina, hair loss, dyspnea, sleep disturbances, poor concentration, and depression. Interestingly, there is a striking similarity between these symptoms and those associated with endometriosis. Despite the striking overlap in symptomatology, the burden of ID and IDA in endometriosis has never been investigated in human studies.

Dr. Hanna Goldberg, PGY3 resident, is spearheading a research project alongside principal investigators, Dr. Ally Murji, associate professor and obstetrician gynaecologists at Mount Sinai Hospital, and Dr. Carmen McCaffrey, assistant professor and obstetrician gynaecologist at St. Michael's Hospital. Their research hypothesizes that there is a high underlying burden of undiagnosed ID and IDA in patients with endometriosis that may be contributing to symptomatology.

“Much more work needs to be done in this area. For endometriosis treatments, sometimes we focus so much on hormonal options or surgical options, but this may be an opportunity for us to focus on other causes for the symptoms, causes that may be easily dealt with,” said the collaborators. “If iron deficiency is really contributing to endometriosis-related symptoms, than a simple test can easily diagnose it and treatment can be quickly initiated.”

The project is a multi-centre, cross-sectional study taking place at Mount Sinai Hospital and St. Michael’s Hospital. Eligible patients with a diagnosis of endometriosis have their bloodwork drawn and fill out a study questionnaire evaluating endometriosis and iron deficiency symptoms using validated scales. The goal is to reach 250 patients in total, with 80 patients recruited thus far.

The research study is the first to investigate ID and IDA in patients with endometriosis. If the result of this study proves a high underlying burden of undiagnosed ID and IDA in patients with endometriosis, gynaecologists would be presented with the opportunity to improve endometriosis symptoms early on with routine screening for ID and IDA and subsequent treatment. The two hospital sites have come together to investigate a facet of endometriosis with the potential to greatly improve patients’ quality of life.