UK Biotech Cyclana Bio is Trying to Understand Endometriosis From the Tissue Up

Endometriosis affects an estimated 10% of reproductive age women worldwide. It is painful, progressive, and despite its prevalence, still poorly understood. The average time from a woman's first GP appointment with symptoms to a confirmed diagnosis is, according to Endometriosis UK, around nine years and four months. That figure has barely moved in years, not because clinicians aren't trying, but because the underlying biology of the condition remains unresolved. There are few reliable drug targets, limited treatment options beyond hormonal suppression or surgery, and almost no tools to distinguish between patients who will respond to one intervention versus another.

Cyclana Bio is working to fill some of these gaps. It’s a Cambridge-based biotechnology company with a specific thesis: that the reason drug discovery in endometriosis has stalled is that it has largely looked in the wrong places. The company believes that focusing on the tissue level, rather than the intracellular mechanisms that have dominated research to date, may reveal the shared causal mechanisms the field has been searching for.

On 19 May 2026, Cyclana Bio announced that it had received Health Research Authority and Research Ethics Committee approval for PEMP (Predicting Endometriosis Mechanisms and Populations), which is a 500-patient clinical observational study. First patients have already been recruited at Peterborough City Hospital, with the Rosie Hospital in Cambridge now also enrolling participants.

What the PEMP study is actually trying to find out

The design of the PEMP study reflects the depth of the unknowns Cyclana Bio is working against. Researchers will collect biopsies and menstrual fluid from both healthy women and those with endometriosis, using the donated material to build physiologically relevant 3D models of the disease in vitro. These models are intended to reveal the tissue-level dynamics, the structural and cellular behaviour, that distinguish endometriotic tissue from healthy tissue.

A particular focus is the extracellular matrix, the scaffolding of proteins and molecules surrounding cells that governs how tissue forms, remodels, and responds to signals. Cyclana Bio says it has already confirmed the ECM's involvement in endometriosis. The PEMP data should tell the company whether that involvement points to a single, shared causal mechanism - one amenable to a universal treatment - or whether endometriosis is in practice several diseases wearing the same name, each requiring a different therapeutic approach.

Both outcomes would be valuable. A shared mechanism would create a tractable drug target at significant scale. A stratified picture would explain why so many treatments have underperformed in unselected patient populations, and point toward precision medicine approaches that have a realistic chance of working.

M. Saikat Banerjee, Chief Investigator at the Rosie Hospital, described the clinical context plainly.

M. Lukasz Polanski, Principal Investigator at Peterborough City Hospital, added:

A tissue-first methodology in a field shaped by intracellular thinking

Dr. Léa Wenger, CEO and Co-Founder of Cyclana Bio, is direct about what she sees as the problem with the existing landscape.

Wenger is also candid about the stakes and the pace.

The study is being funded by Cyclana Bio's £5 million pre-seed round, which closed in 2025. The company says future financing will be used to expand to additional study sites and extend its whole-tissue methodology to other chronic inflammatory conditions that share similar tissue-level characteristics.

The policy context: a strategy that finally names the problem

The PEMP launch arrives weeks after the UK government published its Renewed Women's Health Strategy for England in April 2026. The document is unusually blunt for a government policy paper. The Secretary of State for Health and Social Care, Wes Streeting, opens it by acknowledging that "the NHS has a problem with basic, everyday sexism and an appalling culture of medical misogyny." The data backing that claim is hard to dispute: healthy life expectancy among women in England fell by 2.5 years between 2019–21 and 2022–24, and the UK dropped from 20th to 26th place on female life expectancy among OECD nations between 2000 and 2022.

For endometriosis specifically, the strategy commits to eliminating the "diagnostic odyssey" facing women with gynaecological conditions, and identifies menstrual and gynaecological health as priority areas for the new NHS Online virtual hospital, due to launch in 2027. The NIHR R&D Innovation Catalyst, launched this year, will provide funding and wrap-around support for high-priority health innovations, with women's health explicitly listed as a focus area.

Research is also getting direct attention. The strategy states that the NIHR will now only fund research that appropriately considers sex-based differences. That shift in funding conditions, though straightforward on paper, represents a change in the incentive structure for biotech companies working in women's health. It creates a floor below which research quality on sex-specific conditions is no longer funded, which should in theory pull more rigorous, disease-specific study designs, of the kind Cyclana Bio is pursuing with PEMP, into the mainstream.

A pattern of progress, and its limits

The Cyclana Bio announcement fits into a broader moment of activity in women's health science in England. At BioFocus, we have been tracking several of these developments. Earlier this month we reported on the launch of the FREEDOM trial by Calla Lily Clinical Care, which is evaluating a tampon-like intravaginal delivery device for progesterone in women at risk of pregnancy loss, a first-in-human study addressing what that company describes as an unmet clinical need created by the shortcomings of existing vaginal pessaries. Both FREEDOM and PEMP share a structural characteristic: they are early-phase, observational or safety studies funded by pre-seed capital, doing the evidential groundwork that is a prerequisite for any treatment that might eventually reach patients.

We have also covered two developments in cervical cancer that illustrate how reproductive health innovation is moving across multiple fronts simultaneously. Our analysis of cross-sector collaboration towards cervical cancer elimination examined the systemic barriers that continue to prevent the WHO's 90-70-90 elimination targets from being met, despite the tools to meet them being largely available. Separately, we reported on a study published in The BMJ showing that a modified sanitary pad, worn during menstruation, could detect HPV with accuracy comparable to clinician-collected cervical samples, a finding with significant implications for screening access, particularly among women who avoid clinic-based procedures.

These stories trace a common outline. The problems are well documented and the ambition to solve them is real, but the gap between a clinical study opening and a treatment reaching patients is wide, and for endometriosis in particular, that gap has been wide for a long time.

Final remarks

PEMP is an observational study, which means Cyclana Bio is in the information-gathering phase rather than testing a therapeutic. The 500-patient target is substantial for a pre-seed-funded biotech, and the involvement of NHS Foundation Trusts in Cambridge and Peterborough gives the study institutional credibility. But the path from biological insight to a drug that clears regulatory review is long and expensive, and the endometriosis field has disappointed before.

What Cyclana Bio is attempting (building 3D tissue models from human biopsy and menstrual fluid to interrogate a disease that has resisted simpler approaches) is scientifically coherent and relatively novel. Whether it is sufficient to crack the problem is a question the PEMP data will begin, but not finish, answering.