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A Painless Future? - Dichloroacetate and its Prospective Use in Tackling Endometriosis at its Source.

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The NHS describes Endometriosis as  ”a condition where tissue similar to the lining of the womb grows in other places, such as the ovaries and fallopian tubes.” Yes, this is true; however, the reality of endometriosis cannot be encapsulated by these words alone. The relentless pain, the emotional toll, and the impact on daily life and relationships are profound and often overwhelming.

Affecting 1 in 10 women of reproductive age, one might assume that effective medication exists to target the source of the problem and alleviate the crippling pain experienced by millions. However, this assumption would be incorrect, as current treatment options often fall short in providing comprehensive relief, highlighting the urgent need for innovative therapies. As of now, the primary medical treatments for endometriosis frequently involve contraceptives, which suppress hormones and may have side effects, making them unsuitable for women who are trying to conceive.

Thus, the discovery of dichloroacetate as a potential treatment brings hope to many who suffer from this debilitating condition. By targeting the metabolic abnormalities in cells, it offers a novel approach that could significantly improve the quality of life for affected individuals.

Breaking down the science.

According to the study titled “Nonhormonal therapy for endometriosis based on energy metabolism regulation”, research determined that patients with endometriosis have endometriotic cells that prefer glycolytic metabolism over mitochondrial oxidative phosphorylation to generate the essential energy needed for cell growth. What does this mean?


Mitochondrial oxidative phosphorylation (OXPHOS) is a process that occurs in the mitochondria, the powerhouse of the cell, where energy is produced. During OXPHOS, the mitochondria use oxygen to help convert nutrients, particularly glucose, into ATP, which is the main energy currency of the cell. In simple terms, OXPHOS is the cell's way of efficiently producing energy by using oxygen and nutrients within the mitochondria. However OXPHOS also generates reactive oxygen species (ROS), which are harmful byproducts that can damage cells and lead to cell death.


Glycolytic metabolism, or glycolysis, is a process that cells use to break down glucose to produce energy. Unlike oxidative phosphorylation, which takes place in the mitochondria and requires oxygen, glycolysis occurs in the cell's cytoplasm and does not require oxygen. During glycolysis, one molecule of glucose is broken down into two molecules of pyruvate, producing a small amount of energy in the form of ATP and generating byproducts like lactate if oxygen is low. Glycolysis is a quicker way for cells to generate energy, but it produces less ATP compared to oxidative phosphorylation.



So how does this link to endometriosis and why is it indicative of a new treatment?

By favouring aerobic glycolysis over OXPHOS, endometriotic cells produce less ROS, which helps them avoid the damage that could trigger cell death. This means that patient’s with endometriosis, endometriotic cells are more likely to avoid damage that could trigger cell death. As a result, this will contribute to the progression of the disease as endometriotic cells will continue to develop unchecked.


If this metabolic switch from OXPHOS to glycolysis could be reversed, it might lead to increased production of reactive oxygen species in the mitochondria. Higher ROS levels would cause oxidative stress, which could damage the cells leading to their death (posing as beneficial to those suffering with excessive endometriotic cell growth).

“Suppression of the aerobic glycolytic pathway may become a new target for endometriosis treatment, but studies are still in their infancy”

Dichloroacetate (DCA) and its potential to shift cells from glycolysis back to OXPHOS.



Dichloroacetate (DCA) is a drug that mimics pyruvate, a key molecule in energy production. It works by inhibiting (reduces the production of) an enzyme called PDK (pyruvate dehydrogenase kinase), which normally slows down the process of OXPHOS. Therefore, by inhibiting PDK, DCA activates the enzyme PDH (pyruvate dehydrogenase), which encourages the cells to return to using OXPHOS instead of glycolysis.

If DCA can stimulate this shift, it can alleviate the pain of endometriosis as it will stop the unbridled growth of endometriotic cells.


In a research article published via the University of Edinburgh, it states: “When the cells from women with endometriosis were treated with dichloroacetate, they were found to return to normal metabolic behavior.”

Hope for a better future

Endometriosis casts a dark shadow over the lives of millions of women, inflicting unbearable physical and emotional pain. To see a potential solution emerging - a glimpse of a future where these women are no longer shackled by relentless suffering - ignites a profound sense of hope. It’s the promise of reclaiming lives stolen by this cruel condition, and it fills the heart with the belief that a brighter, pain-free tomorrow is within reach.



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