Endometriosis Is Misunderstood, Needs Better Treatment Plans, Experts Say

about 190 million People around the world live with endometriosis, but experts say it is still poorly understood.

“There are many things we don’t understand about the disease, such as how or why endometriosis develops. It is a subject that is glimpsed in medical school, even if it causes Dr. Austin Findleyan OB/GYN specializing in endometriosis at the University of Kansas Health System, told Healthline.

This condition can greatly affect a person’s quality of life.

“Endometriosis can involve multiple organ systems, and its symptoms are often chronic, significantly impacting work productivity, social life, intimate relationships, and mental health, with significant consequences. It can lead to social costs. Dr. Catherine AllaireCo-author of the review and physician at the Department of Obstetrics and Gynecology, University of British Columbia, Canada and BC Women’s Center for Pelvic Pain and Endometriosis, Vancouver, British Columbia, said in a press release.

Endometriosis can cause a variety of symptoms, including painful cramps, pain during intercourse, bloating, nausea, bleeding, digestive problems, period spots, and infertility.

who Note The symptoms of endometriosis are so varied that even medical professionals can miss them, which can delay diagnosis significantly.

“Among obstetrics and gynecology … if you are caring for pregnant patients in general obstetrics and gynecology, if you are caring for a variety of other problems, or if you are seeing your usual family doctor or They don’t realize this diagnosis when they’re a general practitioner in. It’s not the diagnosis that people really think about it,” he said. Dr. Clara Pikeco-director of the Department of General Obstetrics and Gynecology, University of California, Davis.

“In the pelvic pain and chronic pelvic pain landscape, many doctors mistakenly believe that it is actually a psychological rather than a disease process that causes women to develop pelvic pain,” she said. told Healthline.

Diagnosing endometriosis is not easy. Some guidelines suggest that it is possible to make a clinical diagnosis of endometriosis based on symptoms, physical examination, and imaging studies.

However, the American College of Obstetricians and Gynecologists situation The only definitive way to diagnose endometriosis is by laparoscopic surgery.

Endometriosis is found in the fallopian tubes, ovaries, vagina, cervix, vulva, intestines, bladder, rectum, and other parts of the body.

There is no cure for endometriosis, and treatment focuses on managing symptoms.

Hormonal contraception is a common first step in treatment. surgery It can also be used to remove endometriosis.

Both excisional and excisional surgery are used in the United States.

According to research Excisional surgery is more effective in reducing pain symptoms and is considered the gold standard of surgical treatment among many experts.

However, many women still undergo ablation surgery.

“The issue of ablation is really an afterthought. Doctor.Daniel Jinan expert in minimally invasive gynecologic surgery at the University of California, Los Angeles, told Healthline. But the problem with endometriosis we talk about has always been that lesions can be like icebergs. “Even if you burn the top of the iceberg, you’re still left with an untreated mass underneath.”

Findley argues that lack of clarity and training in proper surgical technique is the problem.

“The degree of disease patients receive and the quality of surgery vary greatly,” he said. “The way we explain this to our patients is that we’re trying to treat this disease like it’s cancer: removing all visible disease while respecting reproductive goals.” It requires the skill to access the retroperitoneal space, the area where the blood vessels, nerves, and ureters reside, as well as the skill to operate on the bladder and intestines. Ablation) just makes me feel more comfortable.”

“Women have no choice. They are taken to [operating room] by people who have been told they are unqualified and unable to get rid of their disease and have not been referred to specialists who can treat them. …Most doctors don’t discuss excision and ablation, and I honestly don’t know if most doctors even realize there is a difference. Patients are told that it is not safe to have surgery to remove endometriosis, but they do not realize that it is not dangerous (complicated and difficult). It will be sent to someone who can help.”

In Stickney’s case, the pain from endometriosis was so severe that Stickney’s doctor did the following: hysterectomy.

However, this surgery is not a cure for endometriosis and symptoms may return after surgery.

“People seemed to focus more on my fertility treatments than on the pain I was suffering. When I became interested in getting pregnant, I forgot about endometriosis and got pregnant.” I was told to focus on the things that I can’t do – pregnancy doesn’t cure endometriosis,” Stickney said.

“I wish I was treated as someone responsible and mature enough to decide that it’s okay not to get pregnant. Patients deserve agency when it comes to their bodies,” Stickney said. I’m here.

Stickney is one of millions of people around the world who fight every day for answers to their pain.

“Too many patients…are victims of a patriarchal attitude that is too capricious, too weak, too talkative towards women,” he said.

Findley argues that people with endometriosis need better care.

“We need to change the standard of care that patients with endometriosis receive. I believe that patients with endometriosis deserve better care. , should start with increasing the willingness to refer to experts and raise the index of suspicion high, and should be a priority for research,” he said.