"Did You know?"

Tips and Information on Endometriosis: A Monthly Feature

June, 2010

Tip: Did you know that Pelvic Diseases Are Generally Not Well Understood?

According to the North American Endometriosis Association Survey (which has a listing of 4000 members), women reported a delay in diagnosis averaging 9.28 years; this includes a delay in the patient seeking help from a physician for an average 4.67 years and a delay of 4.61 years in the physician making a diagnosis of endometriosis.

The reality is that all too often, pelvic pain patients receive inadequate relief from their pain.

Much of the reason for the delay is due to the fact that patients with endometriosis are not taken seriously, compounded by a lack of consensus regarding the best treatment of the disease. In the appropriate situation, medical treatment can be effective (OCP's are usually the first line of defense). Unfortunately, the currently available medical treatments are fairly crude and do not provide a cure. Many current medical treatments including GnRH agonists have significant drawbacks with many patients experiencing side effects worse than the initial symptoms and/or not responding with adequate pain relief, most likely due to the aromatase enzyme activity of the endometrial implants. Many surgeons are still using coagulation techniques to treat endometriosis which most likely results in only a partial de-bulking of the endometriosis tumor, with persistence and rapid regrowth of the disease. For the patient this can mean persistence and/or rapid recurrence of symptoms.

There is an emerging consensus that excision of the endometrial implants with clear margins is the preferred method of surgical treatment of endometriosis. This approach can be technically challenging, and requires the surgeon have the ability, expertise, and equipment needed to dissect and remove all of the pelvic areas deep down to the normal tissue. As with any complex disease, It is important to see a specialist who has a track record of healing these kinds of complex situations.

Submitted by:

Andrew S. Cook, M.D, OBGYN.net Endometriosis Advisory Board Member
Reproductive Endocrinologist / Gynecologist
Medical Director / Founder
Vital Health Institute
http://www.vitalhealth.com/ 
Los Gatos, CA