MMend Study

What is Endometriosis?

Endometriosis is a prevalent chronic systemic condition in Australia, with significant impacts on both affected individuals and the broader healthcare system. According to data from the Australian Bureau of Statistics (ABS), approximately 1 in 7 people assigned female at birth – around 14% – report having been diagnosed with endometriosis by the ages of 44–49. This highlights the substantial burden of the disease across the lifespan, including its association with chronic pain and increased healthcare utilisation.

The condition is associated with a range of pain symptoms (such as chronic pelvic pain, painful menstruation and dyspareunia) and has significant impacts on the quality of life for patients. This complex condition involves inflammation and an altered blood flow in response to endometrial-like tissue growing in locations outside of the uterus. Current treatments for endometriosis-related pain are often ineffective and have a range of off-target side effects. It is paramount to research alternative options that have minimal side effects, are non-invasive and accessible.

Recent research findings suggest that targeting poor blood flow to endometriosis lesions and concurrent chronic inflammation may reduce endometriosis-related pain and even hinder disease progression. Nutraceuticals contain active ingredients derived from natural origins, that may have a therapeutic benefit. Specially formulated nutraceuticals that target blood vessels and inflammatory pathways are being studied in endometriosis pain context. These nutraceuticals have not been commonly known to cause adverse effects when included in the human diet.

Why Does this Study matter?

The MMEND Study addresses a major un met need, Endometreosis affects rioughly 1 in 7 women and cn cause severe, chronic pain. current treamtments such as homrones or surgery are often not fully effective, can have side effects and are unsuitable in the long term.

This study explores mew mechanisms, instead of hormones, MMEND targets:

• Inflammation
• Microvascular dysfunction (blood flow in small vessels)

This is a relatively underexplored pathway in endo metriosis research.

There are potential advantfes if the research is successful, researchers suggest the apporach could:

• Be more affordable
• Have fewer side effects
• Be suitable for long-term use

Researchers at Curtin Medical Research Institute are currently recruiting for a clinical study investigating a new intervention that may provide pain relief in endometriosis.

You may be eligible if you are 18-45 years old, have a diagnosis of endometriosis and experience moderate to severe endometriosis pain regularly.

If you or someone you know would like to know more about the study, please complete the short pre-screening survey to register your interest.

What is the research exploring?

Researchers are testing whether:

• Garlic extract (anti-inflammatory, anti-angiogenic properties)
• L-arginine (supports blood flow via nitric oxide pathways)

or can potentially:

• Reduce pain severity
• Improve quality of life
• Influence biological markers of inflammation and blood vessel function

How is the study conducted?

The study is a randomised, double-blind interventional clinical trial.

The following criteria is required for the study and participant commitment:

• Participants: ~150 people with confirmed endometriosis
• Age range: 18–45 years
• Total duration: ~56 weeks (including screening + follow-up)

Participant must be diagnosed endometriosis:

• Moderate to severe pain
• Aged 18–45
• Not pregnant or planning pregnancy during the study period
• Participants are typically based in Perth, Western Australia due to in-person visits

Intervention structure

• Weeks 0–16:
• All participants take garlic extract (200 mg daily)
• Weeks 17–32:
• Continue garlic extract

Randomised to either:

• L-arginine (1500 mg daily)
• Placebo
• Weeks 33–48:
• Follow-up period (no treatment, ongoing monitoring)

Participants are also required to:

• Track pain weekly
• Attend ~4 study visits
• Provide blood samples at key intervals

What outcomes are measured?

There are two specific outcomes that are measured fot the MMEND Clincial Trial:

The Primary outcome

• Pain severity (multiple types, eg dysmenorrhoea, pelvic pain, dyspareunia)
• Quality of life (Endometriosis Health Profile questionnaire)

The Secondary outcome

Biological and clinical markers, including:

• Inflammatory markers (eg TNF-α, CRP, IL-1β)
• Angiogenesis markers (eg VEGF, HIF-1α)
• Pain perception and global improvement scores

For more information contact:

Email: mmend@curtin.edu.au
MOB: +61 415 121 435