Endometriosis Awareness Month

Endometriosis Awareness Month

By Dr. Sonia Gayete-Lafuente, Fertility Specialist Physician-Scientist at CHR, New York

Since March is Endometriosis Awareness Month, it’s a good time to shine light on a condition that affects millions of people but is still widely misunderstood. Despite how common endometriosis is, there’s a surprising amount of misinformation surrounding it, not only among the public, but even among many individuals living with it.  

To put it in context, endometriosis affects about 1 in 10 women of reproductive age worldwide, which translates to about 190 million people globally. So, endometriosis is definitely not a rare disease, but actually one of the most common GYN we see. And yet, many patients experience very long delays before receiving a diagnosis. In fact, research shows that on average it takes 7 to 10 years from the onset of symptoms to get a formal diagnosis.  

Why does this occur? One contributing factor is that symptoms are frequently normalized or dismissed, often being assumed to be “just bad period pain” or something women are simply expected to tolerate. However, although women’s pain has historically not always been taken seriously enough, it is important to emphasize the following: endometriosis is not merely menstrual cramps. 

So, what exactly is endometriosis? It is a real and complex inflammatory disease, which develops when endometrial tissue coming from the lining of the uterus implants and grows outside the uterus, in the abdominal cavity. These lesions can appear in different locations in the pelvis, including the ovaries, the fallopian tubes, the outer surface of the uterus, and basically anywhere in the abdomen. It can even appear sometimes on the bowels or the bladder, etc. 

The main issue is that, just like the normal endometrium, these implants respond to hormonal changes during the menstrual cycle, but the body cannot shed them in the normal way through the vagina, so they can grow and bleed inside. This can lead to inflammation, painful irritation of nearby tissues, and sometimes scar tissue or adhesions. 

This inflammatory process is what contributes to many of the symptoms patients experience, like:  painful periods, chronic pelvic pain and fatigue, fain during or after sexual intercourse, bowel movements or even urination during menstruation. And as you can imagine, this can have a profound impact on quality of life, daily functioning, and reproductive health.  

A very important aspect of endometriosis is its relationship with fertility. Studies show that about 30% of patients with infertility have endometriosis, and the reasons are complex. The disease can affect fertility by changing pelvic anatomy, increasing inflammatory environment, and potentially affecting egg and embryo quality, and implantation.   

Currently, there is no definitive cure for endometriosis. However, several evidence-based treatments are available to help manage symptoms and improve quality of life. These include hormonal therapies aimed at reducing the growth and activity of endometriotic lesions, pain management strategies, surgical interventions - most commonly laparoscopic surgery - to remove or reduce the lesions, and often a combination of them. 

In many cases, these approaches may also integrate fertility preservation strategies, such as egg freezing, when appropriate. This can be particularly important for women who wish to preserve their reproductive options before the condition potentially progresses or further affects fertility in the future. 

Most importantly and on the bright side, I want to emphasize that most of patients with endometriosis can still conceive, either naturally or with fertility treatments, that holistic therapies should always be personalized, and that if you experience any of the symptoms we have discussed today, don’t be shy and seek GYN attention, because we can certainly help.   

If you have any questions or would like more information, please feel free to reach out. Our CHR team is here to support you, provide guidance, and help address any concerns you may have.