Bay Area Doctors aim to raise awareness of endometriosis and help women get an early diagnosis

Tampa, Florida. – One in 10 women of reproductive age have endometriosis. It is a chronic inflammatory disease that causes severe pain during menstruation, and is also known as a mysterious disease in women. Sadly, there are not enough doctors to diagnose it.

In fact, it takes an average of 8-10 years for women to receive the proper diagnosis and treatment.

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Ashley Maddox, 34, was one of the women who had suffered for years before they could get the help they needed. Her life was put on hold about two years ago when the unbearable pelvic pain during her period prevented her from doing what she loves.

“Really, a couple of years ago, it was when the pain got so terribly bad and debilitating,” Maddox explained. “I had rectal bleeding, I had digestive issues, pain, fatigue. I knew something was wrong. I had to understand what was going on.”

She and her husband, Aubrey, went to a handful of doctors, without answering the unbearable pain she was experiencing.

Photo: Ashley Maddox and her husband Aubrey.

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“It was frustrating. It felt like there was no hope,” Maddox said. “At some point, I went through four or five doctors before I finally got someone who could help me. I wanted to meet a psychologist because that was before some tests, medication, at some point, they were in my head.

“This is something many doctors don't know about. It requires special training,” her husband Aubrey said.

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Endometriosis is a chronic disease in which abnormal growth of cells grows outside the uterus, just like the cells that line the uterus. These cells are implanted in other organs, causing a wide range of symptoms, many of which send women to the ER. A PBS documentary called “Bowery the Belt” in 2023 highlights why endometriosis is often ignored, leaving women to suffer in silence.

That's when Maddox saw an infertility doctor and was recommended to an endometriosis specialist.

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Dr. Emad Mikhail is the medical director of gynecology at TGH-USF health It handles approximately 250 end cases per year. Mikhail traveled the world teaching other hospital systems about the discovery of endometriosis to raise awareness and get early diagnosis among patients.

Photo: Dr. Mothers Mothers Mikhail.

“We have established a new technique for mapping mutual surgery for endometriosis using robot-integrated ultrasound. We first published the technique worldwide and presented it in many countries,” explained Mikhail.

These efforts have made TGH-USF health recognized as a central part of excellence in endometriosis care. He says that women are passionate about confirming that their symptoms are real and that if one doctor pushes your concern aside, he should find another doctor.

“Sometimes they say, 'This is normal' and get fired by their doctors, which is part of being a woman who suffers so badly every month. “This is not the case, so patients need to defend themselves,” explained Mikhail.

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After hearing Maddox explaining her symptoms, he knew it was what she had. MRI and ultrasound confirmed that endometriosis was stage 4.

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“It acts like a cancer that takes years to spread, how it invades, and it takes years to diagnose,” Mikhail said.

Mikhail performed two surgeries at Maddox to remove the fallopian tubes, the appendix, some of the cysts formed around the ovaries, and some of the appendix.

Photo: Ashley Maddox from the hospital.

“My first surgery was six hours and six hours. I was in the hospital for a week, so it was pretty intense,” explained Maddox.

Discovering the reasons behind her symptoms was a painfully long journey, but now Maddox's mission is to raise awareness.

“If I can defend other women for diagnosis and early prevention and just raise awareness, I'm ready. If you don't give up and continue to defend yourself, I'm roaming that there's a light at the end of the tunnel,” explained Maddox.

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Mikhail is able to save Maddox's reproductive organs, and she and her husband are now beginning their IVF journey. Despite infertility being a major symptom of endometriosis, Mikhail said about 60% of patients can become pregnant after treatment.

The risk of endometriosis recurrence is approximately 30%, so patients have multiple follow-ups after surgery. Other treatments for cases of less severe ENDO include medication, diet, physical therapy, and pain management.

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