Question: Have you ever thought about what interesting biological information your menstrual blood holds? No? Just us?
Well, researchers have discovered that the blood we deal with every month might actually be the answer to diagnosing some of the most difficult health conditions women face. And additionally, some of the most underdiagnosed.
In a recent episode of The Quicky, host Claire Murphy found out exactly how a menstrual cycle could be a game-changer for women's health in the future.
Despite being considered a waste product and a burden for centuries, our period blood could actually hold the key to revolutionising women's health diagnosis.
Watch: Here are seven health myths debunked. Post continues below.
In case you missed it, in 2024, there's still a whole heap of common medical diagnoses you're probably more likely to miss, just because you're a woman.
Meaning? There's a lost generation of women going through life struggling with undiagnosed conditions. Unfortunately, many women live with PCOS, endometriosis and other conditions without realising it, and by the time they're diagnosed the impact on fertility is already present.
Now, however, recent scientific advancements have proposed that the answer to this might lie in your menstrual blood, with experts saying that it holds a wealth of information about women's overall health and reproductive system.
Listen: Want to get your ears around the full episode? Check it out below.
As Claire Murphy explained on The Quicky, menstrual blood is a complex mixture of blood, endometrial tissue and cervical mucus — a unique composition that makes it an invaluable source of biological information. Unlike venous blood, which is the blood we have drawn from our arm, menstrual blood provides more than a current snapshot of our health.
In fact, it offers insights into the uterine environment and can potentially reveal early signs of various health conditions — one of the most promising applications of this? Endometriosis.
According to QENDO, endometriosis is a condition where tissue similar to that which normally lines the uterus grows in other parts of the body, usually in the pelvic cavity. The painful condition is something that affects millions of women worldwide. In Australia, one in nine women will be diagnosed with endometriosis by the time they hit their 40s.
However, for something so common, it is notoriously difficult to diagnose and often requires invasive procedures. Australian data unfortunately still suggests that it can be around seven years from the onset of symptoms until the diagnosis is finally made and effective treatment commenced.
The good news? Researchers have found that menstrual blood from women with endometriosis contains unique cellular characteristics and gene expression patterns that could serve as biomarkers for the disease.
Studies have also shown that menstrual blood can be used to detect high-risk strains of human papillomavirus (HPV), the primary cause of cervical cancer. Meaning? It could potentially replace or complement traditional pap smears or cervical screening.
Huge.
In the US, menstrual blood test monitoring has currently been approved by the FDA for monitoring haemoglobin A1C levels, a key indicator of long-term blood sugar control in diabetes patients.
This groundbreaking move marks the first diagnostic test of any kind based on menstrual blood, potentially revolutionising diabetes management for menstruating individuals.
It may also enable us to monitor hormonal imbalances, thyroid disorders, reproductive health issues, certain types of cancer and genetic disorders.
So, how does it all work? And when can we expect something like this to be available in Australia?
Well, at the forefront of menstrual blood diagnostics is a women's health company called NextGen Jane, which created an innovative "smart tampon system" in which menstrual blood is collected and used as medical samples.
On the podcast, Claire Murphy interviewed Ridhi Tariyal, the co-founder of NextGen Jane, and asked her to break down everything we need to know about the process.
How does the 'smart tampon' system work?
"What we've developed is just a translation system that allows us to interpret the signals that your body is giving naturally every single month," explained Tariyal. And it's all through an organic cotton tampon.
Users simply sign up for NextGen Jane clinical studies and receive a kit — a cardboard box that arrives at their house. It contains a 'smart tampon' and a set of instructions. As Tariyal explained, the tampon is placed in your body for about four hours. Once you take the tampon out, it's then placed into a jar that comes in the kit.
"The jar has a preservation buffer at the bottom," said Tariyal. "As soon as you drop the used tampon into the jar and close the top and begin to twist it close the the buffer is released, and so it's mixed in with the material that you've collected on the tampon."
Then, it goes in the mail.
"It travels to our labs back in Oakland, California. So far, it's a national study — we've received samples from as far away as Alaska and Hawaii, but really from everywhere in the US. And it has arrived to us in good shape — from sitting on the tarmac in Texas in the summer to Boston in the winter, it's pretty robust. Once it arrives at our labs, the material is extruded from the tampon and it is then stored in our deep freezer," she explained.
The system is designed to detect warning signals of health conditions, reproductive disorders or treatable infections that can damage female fertility if left untreated.
"When we are ready to do some analysis, we remove an aliquot from the deep freezer and we prepare it for sequencing, which is just a process by which we are looking at the genomic information within that sample."
From here, Tariyal said the team examine this data and determine whether or not the genomic signals from the menstrual blood signals a particular disease or if it compares to a normal, healthy volunteer sample.
"There are many conditions that we are looking into, but the one that we have studied the most is endometriosis," added Tariyal.
What's actually in our menstrual blood?
Blood is the main part of what comes out of us during our menstrual cycle, but there's obviously a bit more to it. So, what other things are actually coming out during our menstrual cycle that can potentially be used for diagnostics?
"The entire purpose of menstruation is to shed the endometrial lining — and so there are a lot of cell types that we have access to that you would not if you were just to do a normal blood draw. And those epithelial and stromal cells that make up this endometrial lining are super interesting because if there is something different in them we think that that can be a direct indicator of disease."
Enter: Endometriosis.
"The other thing that I always like to highlight is that if you take a blood draw in the typical way, you should have essentially no bacteria. Your systemic blood is a pristine environment. But when you look at menstrual blood, you definitely see a very remarkable microbiome signature."
This microbiome, Tariyal said, is very interesting and helpful to track for potential dysbiosis, which is when the composition of bacteria is not optimal for what should be within the utero lining.
How close to a reality is an endometriosis test using menstrual blood?
So, will this eventually be a non-invasive test that can confirm whether someone has endometriosis or not? How far away are we from that being a reality?
"I think it's really close," Tariyal said on The Quicky. "We've been working in this space for 10 years, and there are other great researchers, one of them actually based in Australia, that has been looking at menstrual blood for a long time."
And there are a couple of factors that make Tariyal optimistic that we're closer than ever.
"One is just the sheer volume of research that now is happening in the space. It's not just us, it's not just the researcher in Australia, there are researchers in the UK and other labs in the United States. I think that there's no turning back this momentum. We will start to evaluate menstrual blood as a really interesting sample type for many, many diagnostics.
"I think everyone has landed on the fact that endometriosis is incredibly difficult to diagnose, and it has this awful diagnostic odyssey and a huge length of time before you find out what you have. So there actually has been this real focus on looking at menstrual blood for specifically diagnosing endometriosis. And our research, and the research that we are reading in the literature, really point to the fact that we think that we are probably within years to having an endometriosis non-invasive diagnostic."
Which is… huge.
Of course, it's not just endometriosis the 'smart tampon' can diagnose but a wealth of other health conditions — such as viruses, bacteria, gonorrhea, chlamydia and HPV, which leads to cervical cancer. What's more, it could also be indicative of fibroids, adenomyosis, PCOS and other reproductive conditions.
"Trying to look at and isolate rare cells from things like ovarian cancer or endometrial cancer can be found earlier and earlier by looking at menstrual blood. And I think that that's going to be really exciting."
So, when will this be available in Australia?
The short answer? Not anytime soon.
Claire Murphy also spoke with Caroline Gargett, Adjunct Professor in the Department of Obstetrics and Gynaecology at Monash University and head of the research group Endometrial Stem Cell Biology.
According to Gargett, Australia is just not there yet when it comes to the advancements in using menstrual blood as a diagnostic tool.
"I think we've probably got a little bit more to go," she told Claire. "We're looking at different ways of how we can use menstrual fluid for diagnostics, and we're really wanting to actually first establish a biobank. We've got lots of samples to manage this, and we will be looking at perhaps five different components of the menstrual fluid. We're also looking at a novel way of collecting menstrual fluid as well and developing a device for this."
Up until now, there's been hope that eventually there would be that a simple diagnostic test developed and ultimately, some form of drug therapy to control the symptoms without the need for invasive surgery.
While this has proven elusive as yet, experts like Gargett are hoping this may be the answer to the future of women's health diagnosis in Australia, particularly endometriosis.
"It's a non-invasive source of endometrial tissue — so you don't actually have to have a laparoscopic operation to get endometrial tissue," Gargett said on The Quicky. "It's actually in your menstrual fluid. And the thing is, we can culture it and use it to test drugs or even the hormones that women take and look at their action with those within those organoids."
"It's really like a personalised medicine approach, growing the cells up from the individual and then testing their responses — sort of more of a functional assay."
What do you think of the above? Is this something you would try if it was available in Australia? Share with us in the comment section below.
Feature image: Getty