Endometriosis Treatment: Can Endometriosis Be Treated Without Surgery?
Endometriosis is an extremely painful chronic condition, which often also leads to infertility or subfertility, that affects about 10 percent of women worldwide. It is characterized by growth of endometrial-like tissue, which normally lines the inside of the uterus, outside of the uterus on pelvic organs, the abdomen, bowel, and beyond. This tissue is not the same as the endometrium, characterized by very different behavior and unique molecular profiles.
Eventually, personalized “theranostic” (therapy and diagnostic) tools will exploit these unique molecular profiles and lead to far better diagnosis, therapy and monitoring approaches. Research is accelerating in this area, which is already very pervasive in other diseases such as cancer and various immuno-inflammatory conditions. Meanwhile, the only therapies that are available to actually treat endometriosis, not just the symptoms, are purported to be hormonal options and excisional surgery. However, there are major limitations to the argument that hormonal therapies actually work very well to treat endo rather than simply reduce symptoms.
Thus, in a word, “can endometriosis be treated without surgery?”, the answer is a resounding NO ! That is not to say that hormonal and other treatments, mainstream and integrative-holistic, can’t help make your life better. They can. Let’s unpack this a little bit to give you a roadmap of the options.
Understanding Endometriosis
The exact cause of endometriosis is technically unknown, but we know it is influenced by genetic, genomic, hormonal, immunologic and environmental epigenetic factors. In other words, it is “multi-factorial”. This means the reason you may have endo could be different from why your friend or even your sister does. Endo can also behave very differently because different factors are probably in play in different people. This makes a “standard treatment” hard, if not impossible, to recommend to any given patient. This is changing with the advent of endometriosis bio-molecular pathway research, which will lead to highly individualized targeted treatments. But this is not part of what is available today.
Diagnosis of Endometriosis
Diagnosing endometriosis is very challenging, because the symptoms can mimic other conditions. This is part of the reason that diagnosis is often delayed by 5-10 years and intentional or inadvertent gaslighting is rampant, depending on which specialist was consulted. The doctor may be looking at you through a general practice medical lens, or intestinal, urologic, neurologic or other lenses in forming their opinions.
Rule # 1 is to listen to the patient. This is almost never done to an appropriate extent. Why? Because today’s medical system limitations often lead to five to ten minute visits with a semi-interested and overworked provider who is likely under-informed regarding endometriosis.
When rule #1 is broken, an appropriate evaluation and testing is not likely to be done. Ideally, a clinical suspicion leads to testing that may include ultrasound or MRI, various blood tests, testing for associated conditions and so on. None of these will reliably lead to a diagnosis of endo but can lead to appropriate specialist referrals to get to the root cause of pain, such as endo.
Rule #2 in medicine, in general, is to get a diagnosis before recommending treatment. This is because treatments can be ineffective when treating the wrong condition or, worse, can lead to complications and side effects. Unfortunately, in the author’s strong opinion, this is often violated specifically in endometriosis treatment. A common standard is to offer hormonal therapy to patients to see if it might work because the diagnosis might be endometriosis and endo is, in part, fueled by hormones. This may or may not be reasonable depending upon individual circumstances and choices.
This brings us to rule #3, that we’ll cover next, which proposes that patients should be offered treatment options to select from after informed consent about the potential risks vs the potential benefits based on the best possible scientific evidence. This is not always done very well and certainly depends on the “trust factor” with your selected specialist(s), since scientific evidence is subject to interpretation. Most patients do not realize this.
Conventional Treatment of Endometriosis
Traditional treatment for endometriosis often involves medication or surgery. Medications can include pain relievers and hormonal therapies. In the near future medications will include targeted biomolecular non-hormonal therapies, but they are not here yet. Pain relievers are obviously a symptom reducing band-aid and are not intended to treat, so we will not discuss them here either. They can certainly help in overall management but we will focus on “treatment” in this article.
Hormones aim to either shut down ovarian function (in other words, cut off estrogen) or at least regulate the menstrual cycle, and progesterone analogs, to potentially reduce the growth of endometriosis tissue.
Surgery is used for definitive diagnosis of endo as well as treatment by removing any lesions or implants that are found. In some cases the two modalities can be used hand in hand, but the order in which they are used and the nature of the proposed hormonal therapy are important considerations.
Hormonal Treatment
International guidelines are very confusing and inconsistent regarding hormonal therapy. Because of this, recommendations can vary between practitioners. We won’t delve into all of these options here but the following are excellent summary articles on this important topic.
Read More: Endometriosis Guidelines: A Closer Look at a Potential Source of Confusion in Treatment Debates
The important points to consider are as follows:
- The ONLY way currently to definitively diagnose endometriosis is through biopsy, usually performed during surgery.
- Starting treatment that can cause extreme side effects and potential long-term harm without first getting a definitive diagnosis seems imprudent. So, if a practitioner offers hormones because they “think” you have endo based on history, examination and perhaps some scans, at least get a second opinion from an endometriosis specialist. This approach is within international guidelines but can cause you a world of misery and potential harm if not managed in expert hands.
- Hormone therapy for endo boils down to either reducing or eliminating estrogen, or increasing progestational agent levels to try to medically eliminate endo lesions.
- Endometriosis cells differ from endometrial cells that are found in the uterus by being relatively resistant to synthetic progestin or natural micronized progesterone therapy.
- Hormonal therapy is known to reduce pain when endometriosis is the cause. However, studies have shown that it fails to actually retard the growth of endometriosis tissue when objectively tested in pathology laboratories after hormonal therapy. Further, hormonal therapy cannot eliminate scars or fibrosis caused by endo and this fibrosis by itself can be a cause for pain.
- While unproven, under some circumstances it may be prudent to use less toxic hormonal therapy options to potentially reduce the risk of endo recurrence after surgery.
Surgical Treatment
When symptoms, history, physical exam, scans and laboratory evidence all point to endometriosis as a strong possibility to be the root cause of pain, and/or infertility, minimally invasive surgery should be considered to find out for sure. If endo is diagnosed, then medical hormonal therapy may make sense as part of a highly individualized treatment plan under the guidance of an endo specialist.
The caveat to considering surgery is that there are, of course, potential risks and complications even though it is minimally invasive. These risks can be minimized in the hands of an expert surgeon, but they should be considered in a risk-benefit discussion.
More importantly, assuming you have identified an expert endo excision surgeon, surgery is the cornerstone to current effective treatment. While incompletely proven, for many reasons, it appears that excision of endo lesions rather than burning away (fulguration) is a better and safer approach. To discover more about surgical considerations, consider the following articles.
Read More: Breaking the Cycle: Understanding Endometrioma Recurrence After Surgery
Integrative Holistic View of Endometriosis
Since the cause of endo is incompletely understood, but highly multifactorial, and because the reason endo is present in any given individual may vary, either surgery or hormonal therapy or both may fail. Failure is relative. In other words, failure may be defined as no immediate pain improvement, persistent subfertility, or it may mean recurrence years later. These are very different scenarios, requiring different approaches. Also, it’s important to consider whether or not associated conditions have been addressed, such as SIBO or other microbiome irregularities, other inflammatory immune-modulated disease and so on. Finally, pelvic floor physical therapy is not just a symptom band-aid but a critical co-treatment for pelvic floor function before and after surgery. These topics are all beyond the scope of this article but you can discover more by reading the following articles.
Read More: Pelvic Floor Physical Therapy: What you Need to Know
If expert excision surgery and supportive hormonal therapy, when used, fails to alleviate pain then supportive pain management can still improve quality of life. This can be mainstream pain and anti-inflammatory medications, nerve block injections, electrical stimulation modalities and/or more holistic approaches including acupuncture, acupressure, mind-body biofeedback approaches such as HeartMath, herbals, aromatherapy and more.
Read More: Integrative Therapies for Endometriosis
Kicking it up a notch, here is something you do not see covered much other than in a very superficial manner. It is not rocket science, but is not simplistic at the potential treatment level either. However, it is something you can implement in a proactive way at any point in your journey. Specifically this is the impact of nutrition and lifestyle choices, as well as well-selected and targeted supplements, but drilled down a lot further than simply eating right, exercising and de-stressing.
Upcoming bio-molecular therapies will target specific biological pathways that we are now beginning to better understand. Many pathways are already identified, many not. The problem is that there are no mainstream medical therapies yet which can target these pathways safely and effectively. We know from other related genomically modulated inflammatory diseases, like cancer and auto-immune disorders, that these treatments take a while to develop and offer safely. Meanwhile, many of the genomic, metabolic and epigenetic abnormalities that influence endo are known or at least partly known. With few exceptions, while it is too early to safely use pharmaceutical agents to modulate these abnormalities, nutrients, specific exercise, toxin avoidance, and even state of mind can affect the same pathways abnormalities without risk.
Nutrigenomics and Epigenetics
How do toxins or stress adversely affect your health, while healthy diet and exercise positively influence your health? In large part, relatively new sciences like metabolomics and genomics, and their derivatives, explain this. You are born with your genes and, so far, you can’t alter that deck of cards. Some genes may be “bad” and increase your risk of endo, as well as other diseases. However, not everyone with some bad genes develops disease. The most famous examples are identical twins who inherited the exact same genetics yet might look a little different (e.g eye or hair color) and often get different diseases. Why?
Anything and everything you eat, drink, get exposed to via skin or breathing, or even think about or emote, can affect your genes through epigenetics. This means these substances and neurochemicals, good or bad, can turn genes on and off. Of course it is infinitely more complex than that and multiple genes affect one process in many cases. However, you can actively modulate your inflammatory and oxidative state. Do we know what veggie or what thought or what toxin turns what specific gene on or off? No. But we do know how these gene controlled pathways synergize and work together to create health or facilitate disease.
Conclusion
Surgery is a cornerstone to definitive diagnosis of endo and serves as very important part of treatment. The path to success is a correct diagnosis, attention to detail and a highly individualized treatment plan. This can only be carried out in consultation with endometriosis specialists in medical and surgical management.
Unfortunately, it is not easy to find someone or a team that can fit your needs but it is a crucial step forward to seek out the best you can. The more complex your situation (e.g. possible advanced disease or repeat surgery) the more you need an excision surgeon with master surgeon skills. Ideally you want a specialist who is not only a surgeon but also capable of guiding you through any additional treatment options you may need, mainstream and holistic. While a master excision surgeon and integrative endo specialist is hard to come by, many have a team that can fulfill your needs.
References:
Endometriosis: Etiology, pathobiology, and therapeutic prospects
Brassica Bioactives Could Ameliorate the Chronic Inflammatory Condition of Endometriosis
Diet and risk of endometriosis in a population-based case–control study
Emerging Drug Targets for Endometriosis
Can Endometriosis Grow Inside the Bladder
Endometriosis, a medical condition that affects many women worldwide, is often associated with the reproductive system. However, this disorder can manifest in other regions of the body, leading to a pertinent question:
Can endometriosis grow inside the bladder?
In this article, we will explore the nature of endometriosis, its ability to affect the bladder, the related symptoms, causes, diagnosis, and available treatment options.
Understanding Endometriosis
Endometriosis is a gynecological condition where cells similar to the ones lining the uterus, known as endometrial-like cells, grow outside of the womb. These cells can attach themselves to various organs such as the ovaries, fallopian tubes, and in rare instances, the bladder. This phenomenon is known as bladder endometriosis.
Read More: Endometriosis and Inflammatory Bowel Disease: Distinguishing the Differences
Bladder Endometriosis: An Overview
Bladder endometriosis is a specific form of endometriosis where endometrial-like cells grow inside or on the surface of the bladder. These cells respond similarly to hormones as the cells within the womb, causing them to build up, break down, and bleed. However, being outside of the uterus, these cells have no way of exiting the body, leading to inflammation, pain, and scar tissue.
Bladder endometriosis is considered a rare form of the disorder, affecting only about 1 to 2% of patients with endometriosis. However, for those suffering from deep endometriosis (DE), a severe form of the condition, the prevalence increases to nearly 50%.
There are two types of bladder endometriosis:
- Superficial Endometriosis: Endometrial-like cells are found on the outer surface of the bladder.
- Deep Endometriosis: Endometrial-like cells infiltrate the bladder lining or wall. This infiltration can cause a nodule, potentially affecting the ureter.
Read More: What Does Bowel Endometriosis Feel Like? Understanding the Pain and Symptoms
Recognizing the Symptoms of Bladder Endometriosis
The symptoms of bladder endometriosis can vary, often aligning with the menstrual cycle and intensifying during or just before a period. However, many women may remain asymptomatic until the disease has progressed significantly.
Common symptoms of bladder endometriosis include:
- Bladder irritation
- Urgency to urinate
- Pain when the bladder is full
- Occasional presence of blood in the urine during menstruation
- In some cases, pain in the area of the kidneys
Identifying the Root Causes of Bladder Endometriosis
The exact cause of bladder endometriosis remains unknown. However, several theories have been proposed, including:
- Early Cell Transformation: Cells leftover from embryonic development may transform into endometrial-like cells.
- Surgery: Endometrial cells may spread to the bladder during pelvic surgeries, like a cesarean delivery or hysterectomy.
- Hematogenous/Lymphatic Spread: Endometrial-like cells might travel through the blood or lymph system to the bladder.
- Genetic Factors: Endometriosis has been observed to run in families, indicating a possible genetic link.
Diagnosing Bladder Endometriosis
Bladder endometriosis is diagnosed through a comprehensive evaluation involving a physical examination, medical history, and various diagnostic tests. These tests may include:
- Vaginal examination
- Ultrasound
- Urine sample analysis
- Cystoscopy and Laparoscopy
- CT and/or MRI scan
Bladder Endometriosis Treatment Options
The primary aim of bladder endometriosis treatment is to control symptoms and inhibit the growth of endometrial-like cells. Treatment options include:
Medication
Hormone therapy can slow the growth of endometrial-like cells, relieve pain, and help preserve fertility.
Surgery
Surgery is typically required for bladder endometriosis. The surgical options can vary depending on the severity and area affected. The areas affected by endometriosis can be excised to remove them.
Complications and Prognosis
If left untreated, bladder endometriosis could lead to kidney damage. However, surgery can prevent this complication. The condition doesn’t directly affect fertility, but if endometriosis is present in other parts of the reproductive system, conceiving might be challenging.
Endometriosis, including its bladder variant, is a chronic condition that can impact daily life. Yet, it can be effectively managed with proper treatment and a supportive healthcare team.
Read More : Life After Endometriosis Surgery: A Comprehensive Guide
Final Thoughts
So, to answer the question, Can endometriosis grow inside the bladder? — yes, it can. However, through increased awareness, early diagnosis, and effective treatment strategies, bladder endometriosis can be managed, improving the quality of life for those affected.
References:
https://www.endometriosis-uk.org/endometriosis-and-bladder
Bladder Endometriosis symptoms
Endometriosis Symptoms And Treatments
https://www.healthline.com/health/womens-health/bladder-endometriosis
https://consultqd.clevelandclinic.org/urinary-tract-endometriosis-has-serious-health-implications/
Finding an Excision Specialist: What you Need to Know
Finding a true excision specialist is difficult for many reasons, including the paucity of skilled surgeons and the financial burden that may come with when you find one that is a good fit for you. So, the first step is to find the right surgeon and the second step is determining how to navigate the financial implications. It’s important not to do it the other way around because initial botched surgery and treatment can make it that much more difficult to find relief. Surgery is never easier the second or third time around.
There are a small handful of carefully monitored sites with very helpful information and a listing of qualified surgeons based mainly on patient outcomes feedback, none better than Nancy’s Nook. While there may be a few others that share patient experiences and some information, most are not well monitored or refereed, and thus, information and surgeon leads must be viewed with caution. Nancy Petersen has a vested personal interest in endometriosis and a deep understanding of the disease based on her work for many years with Dr. David Redwine, a pioneer in the field. Thus the information which is refereed by Nancy and her hand-picked editors forms a solid base. However, patient feedback, while important, is not the only way to determine who to pick as your surgeon.
The degree of a surgeon’s true technical skills is not easy to judge, especially if you are in the majority of not being medically trained yourself. Review of resumes and asking questions such as where did you go to school or train or how many cases do you do leaves a lot to be desired. It is simply not an accurate reflection, although knowing the surgeon’s background and pedigree can help. So, what else can be done to help find the right surgeon for you?
iCarebetter was created to help those in need find a specialist with a bit more objective information than patient recommendations alone. iCarebetter includes surgeons who are video-vetted by a peer review process. This means that acknowledged experts review surgical videos submitted by surgeons who wish to be vetted and are objectively either verified or not as possessing a high level of surgical capabilities. Of course, this does not reflect total patient management and bedside manner and more subjective skills. However, you want someone who can get the surgery properly done at the highest possible level for your needs. There is something to be said about a surgeon who is not afraid of showing other, perhaps better, surgeons what they’ve got, so to speak.
Additional related reading: Why was iCarebetter built?
Not too long ago, it used to be that when you showed up to your appointment and asked the surgeon what type of surgery they perform, you typically would hear ablation or excision. More recently, many more have adopted excision as the preferred method, or at least talk that way. But outcomes are variable among those receiving “excision surgery,” why? This article will help you better understand some of the key takeaways in finding the right surgeon for you. Some are simply not at a high enough skill level to help you, and others do not walk the talk.
Additional related reading: Laparoscopy: A Common Treatment for Endometriosis
Excision vs. Ablation
Excision is the removal of tissue diseased with endo, whereas ablation is the burning or fulguration of endo lesions and surrounding tissue and organs, usually using electrocautery. Research shows both may be effective for superficial endometriosis and not near delicate structures such as bowel and ureters; however, it is usually not possible to accurately determine which are superficial or deep infiltrating lesions based on looking at them.
While some patients do symptomatically improve with ablation surgery, clinically, it is recommended that excision is the preferred method because you really cannot know if a lesion invades deeper into the tissue, until you remove it. It is likely that those who have benefited from ablation surgery probably only had superficial lesions, and those who did not improve likely had more extensive endometriosis that was missed or not fully eradicated. While this is clinically accepted, we need more research to confirm this and show it truly is the preferred method. The problem with designing an accurate research study for this question is that the skill of surgeons participating in clinical trials is highly variable, so the results can be completely wrong because it almost entirely depends on surgical skill. More importantly, one size does not fit all, and everyone is different. Hence, a truly expert surgeon who can determine and act appropriately on findings and nuances is critical to your personal success.
Important terms and approaches
- Wide excision is a term you may hear which means that there is a wide margin of tissue that is removed to ensure that only healthy tissue remains. There is no consensus on this topic. Some surgeons will adopt wide excision, while others will remove the individual lesions, perhaps leaving micro-diseased tissue behind that is difficult to visualize during surgery. These areas may develop endometriosis in the future. In an expert’s hands, it is a judgment call as to how wide any given area of excision should be. There is a balance of too much and not enough, and this requires a high level of expertise to optimize benefits and minimize harm.
- Combination of excision and ablation. The other consideration when it comes to excision surgery is that some surgeons adopt a combination of excision and ablation. Some tissue will be excised for histological confirmation of the disease, but then many lesions may be ablated instead of excised. This generally does not make sense unless the surgeon simply does not believe that excision is better. The only exception is the ablation of tiny lesions on sensitive areas, such as the ovarian surface, where fertility preservation is a concern.
- Incomplete removal of lesions. Most general gynecologic surgeons will not be able to excise very many lesions and will handle them by fulguration or ablation. Some surgeons may be able to excise the majority of lesions but do not have extensive training to remove all lesions. Hopefully, your surgeon will advise you of their limitations prior to rather than after your incomplete surgery. However, in some cases, endometriosis is not suspected prior to surgery, and a general gynecologist, who is most often not trained in higher-level excision techniques, is caught by surprise. In that case it is better to biopsy, prove that endo exists, and refer to a specialist rather than poorly perform an incomplete surgery.
Complete excision, especially in a difficult case where there is a lot of disease or perhaps in case of distorted anatomy due to repeat surgery, will only occur with a surgeon who has been additionally trained not just in MIGS (minimally invasive gynecologic surgery) but in endo excision per se. The main surgeon has to be an expert because it is never possible to predict how much endo there is, even if imaging scans are negative. Beyond that, if the main surgeon is not trained to perform bowel or urologic surgery, then a well-coordinated team is mandatory. The problem is that this coordination is not too tightly organized in many centers. Ask questions about who can do what, if any required supporting surgeons are in surgery from the beginning or “on call” when needed. The latter does not often work out too well because of other commitments that might be conflicting.
What if I Cannot Afford to see an Excision Specialist?
It is true that many of the surgeons that specialize in excision surgery are out-of-network providers. However, in the past couple of years there have been more surgeons that do take insurance and hopefully, with legislative efforts and more education, this trend will continue to grow.
That being said, there is a good reason why many do not take insurance, and even if you have the option of an in-network provider, it may not be the right surgeon for you. Currently, there is no difference in the coding when undergoing laparoscopic or robotic surgery for endometriosis that discriminates between ablation versus excision. Ablating lesions takes far less skill, time and effort than excision does. Meaning, that an in-network surgeon who performs an ablation surgery that takes one hour will get paid the same as an in-network surgeon who does an excision surgery that takes four hours. Becoming a trained excision specialist costs money to the provider to undergo extra training to be able to perform these types of procedures, and even more training to become an expert in robotics.
Until our payment, insurance, and coding systems catch up to what is required, we will likely not see a dramatic shift in those who take insurance.
Aside from the financial difference, those who are in-network may not be able to spend the amount of time you may want during office visits to discuss the details of your surgery and your overall case as those who are out-of-network. Out-of-network doctors are usually able to provide longer visits to address your concerns in depth instead of the standard 15-20 minutes you typically get with your regular OBGYN. Some choose cost over this important treatment planning time, but there are many people who value a personalized approach which takes more time over the cost of the surgery. It is not just excision surgery that will get you to where you want to be, and this personalized treatment planning includes very important discussion about pre-operative and post-operative healing options.
Whatever you choose, you want to feel comfortable with your surgeon and find the right fit for you.
Other Considerations: Some Tips on Navigating the System
- Change your insurance provider. I know this is easier said than done, but for those with HMOs who are only allowed to stay within a small network, it may be worthwhile to talk to your employer, or partner (if applicable), or do some research on what other insurances are available to you. PPO plans include their list of in-network providers but also often provide some reimbursement for out-of-network providers, especially if their surgeons are not at the skill level that you need or are not within a reasonable geographic range. Open enrollment is typically once a year, or when you change jobs, or due to other qualifying life-changing events. So consider this as an option that may allow you to have more latitude and choice when planning for surgery.
- Work with your insurance company. This does not always work, and is time-consuming, but can have a big payoff at the end. There have been patients who have communicated and worked with their insurance companies when there is no available specialist around to cover your out-of-network provider services. While this has worked for some, be ready for a time commitment and likely many phone calls to get to the person who can help you.
- Ask the doctor you have selected. Some excision specialists have been helping patients with this insurance negotiation conundrum for many years. Because of that, some have teams that help you get an exception and lower your out of pocket costs tremendously.
- Adopt a new perspective. Lastly, this will not necessarily save you money, but looking at your surgery as an investment in your health may make it seem more doable. We often do not think twice about financing $30-$40k on a car or the thousands of dollars we spend on “stuff,” but we often hesitate when it comes to our health. Without health, nothing else matters. For many, excision surgery has been life-changing, and thinking of paying for your surgery as an investment in your health, may be the best thing for you. Again, while upfront costs may seem high, a concerted effort to find the right surgeon, advocate for yourself, and ideally find a surgeon’s office that can help you negotiate and advocate can lead to lower final out-of-pocket costs than you might think.
Whatever route you take, it needs to be the best route for you, with a full understanding of the pros and cons. Take your time when finding the right surgeon, and don’t rush into something you are not comfortable with.
Additional reading: 7 Ways to Prepare For First Endometriosis Specialist Appointment
Does Endometriosis Cause Infertility? Covering the Basics
Learn More About the Connections Between Endometriosis and Infertility
Endometriosis (endo) diagnosis can be a frightening thing. Very frightening. While this inflammatory condition can be binary or non-binary, women of child-bearing age are prone to issues with reproduction due to endo. So does endometriosis cause infertility? Keep reading as I break down the basics on this topic. I will also discuss the emotional impact on patients.
What is Endometriosis?
Endometriosis is a chronic inflammatory condition. In this disease, endometrium-like lesions (the tissue that lines the uterine walls) grow outside the uterus. These glands or stroma cause chronic inflammatory reactions. Endometriosis tissue can occur on the surface of other body parts in the pelvic cavity and distant organs such as the diaphragm, lung, and heart.
Because these endometrial-like lesions shed blood and tissue, many problems result. Pain is a common symptom because the blood and tissue have no way to leave the body. This pressure can result in unbearable pain and other symptoms. If you would like to learn more about what endometriosis is, check out our previous article.
What Happens When Endometriosis Does Cause Infertility
It can. 25 to 50% of women with infertility have endometriosis, and 30 to 50% of women with endometriosis have infertility. However, it is very encouraging to know that most women with endometriosis can become pregnant.
This statistic is significant. Many younger women with this disorder feel psychological effects due to the possibility of not being able to have kids. Not all patients carry this same sentiment. Growing numbers of people do not want to have children. However, for those who do, these thoughts and emotions about fertility can be devastating. Then, endometriosis patients who do conceive often worry about the pregnancy and subsequent delivery of the baby.
How Endometriosis and Fertility are Connected
The association between endometriosis and infertility is well-established. However, there may be multifactorial reasons why it occurs, including molecular, mechanical, environmental, and genetic causes.
There are some theories to explain infertility in endometriosis. The following are just a few:
- Inflammation leads to the production of chemicals known as cytokines. These cytokines can inhibit the egg and sperm from meeting each other, which makes fertilization more difficult.
- Endometriosis-related scarring and adhesions can block the fallopian tubes or uterus space. This blockage makes it difficult for the sperm to meet the egg and implant in the endometrium.
- Endometriosis lesions on the ovaries can inhibit ovulation and block the release of an egg.
Read More: How Does Endometriosis Cause Infertility?
Other Data on Endometriosis and Reproduction
Studies have also demonstrated that the enzyme, Aromatase may also play a role in endometriosis infertility. There is an abnormally high level of this enzyme in the endometrium and endometriosis lesions in patients with endometriosis. In the uterus, this enzyme may affect both natural endometrial development and its receptivity for the implantation of the fetus.
Progesterone is another hormone that may play a role in implantation failure. Resistance to this enzyme can affect reproduction, as it is necessary for a normal pregnancy. In some studies, progesterone receptors displayed abnormalities and caused dysregulation in the endometrial layer of the uterus in patients with endometriosis. Levels of progesterone should increase with pregnancy, but with endometriosis, this process is delayed and can cause an unopposed estrogen state that cannot sustain fertility.
Endometriosis Infertility Treatment Options
Patients with endometriosis do have a substantial risk of infertility or problems getting pregnant. According to studies, the amount of endometrial-like tissue visible during a laparoscopy correlates with the possibility of future fertility. For this reason, if you have endometriosis and would like to become pregnant, early treatments for endo and fertility are crucial. This is because the stage of endo might progress within time, which increases the risk of infertility.
Laparoscopy: A Common Treatment for Endometriosis
Can endometriosis cause infertility? Yes, in some patients. However, in most cases, endo does not entirely prevent conception. Traditional treatments for endometriosis approached most cases of endo with total hysterectomies. But these approaches are now outdated. New science-based evidence shows that hysterectomies and oophorectomies are not always needed. That is because these surgeries do not often work to remove all the endometriosis tissue.
A skilled endometriosis specialist goes in the pelvic and abdomen with thin tubes and excises the endometrial-like tissue for best surgery results. This surgery often requires OB-GYN surgeons with advanced training in endometriosis treatment. It typically involves advanced surgical equipment, such as laparoscopy, robotics, and AI technology.
Now let’s review the endometriosis treatment options in the context of pregnancy and fertility.
Medical Treatment Options for Endometriosis
- Ovarian suppression, such as hormonal therapies or oral contraceptives, is not recommended for women who wish to conceive. This highly-debated advice gained support from a large study that found no difference in pregnancy rates and live birth rates in patients with endometriosis who took a hormone vs. placebo.
- An endometriosis diet by nutritionists that work on endo can be helpful. The diet can help increase the patient’s likelihood to conceive with endometriosis and maintain that pregnancy to a full-term birth.
- The Guideline Development Group (GDG) does not recommend the prescription of adjunctive hormonal treatment before surgery in infertile women with endo.
Surgical Treatment Options for Endometriosis
- The goals of surgery are to remove all macroscopic endometriosis implants and return the pelvic cavity to normal anatomy. While these are the goals, not all surgical procedures or endometriosis specialists will stop this inflammatory disorder or restore the pelvic cavity to its normal anatomy.
- It’s crucial to weigh the pros and cons of surgical intervention.
- Endometriosis minimal invasive surgery by an expert is the preferred surgical procedure because:
- It causes minimal damage to the tissue.
- It’s assisted with magnification.
- There is a relatively fast recovery time.
- Mostly only a short hospital stay is involved.
How Women with Endometriosis Suffer Emotional Impact
Women who deal with endometriosis reproductive problems may experience a variety of feelings, such as:
- Stress
- Worry
- Grief
- Confusion
- Anger
- Sadness
- Feelings of inadequacy
As mentioned above, over 30% of women with fertility problems have endometriosis. If a woman is already distressed about becoming pregnant, the shock of an endometriosis diagnosis may amplify those emotions.
Furthermore, women with endometriosis may feel further pressure to have kids sooner to increase their likelihood of success. But, that’s not always practical. Some do not have a partner or might not even know if they want to have kids. Perhaps they are with someone who does not wish to or is not ready for kids. They might also be with someone they have not been with for very long, so they are unsure if they want children. Many factors can cause stress on women with endo to try to get pregnant right away.
For those ready and trying to get pregnant, fertility issues caused by endometriosis may also create feelings of frustration, hopelessness, and sadness. These feelings are the reasons why it’s crucial to incorporate a mental health expert as part of your holistic endometriosis treatment team.
Psychological Impact of Fertility Treatment for Endo Patients
Furthermore, a whole new slew of emotions comes with those patients who move on to endometriosis fertility treatment. Excitement. Happiness. Disappointment. Sadness. You and your partner can do these things to help prepare for these possible feelings:
- Prepare and be ready for the emotional journey ahead
- Cope with grief and loss associated with unsuccessful prior attempts or miscarriages
- Develop strategies for coping with the news of other people’s births and pregnancies
- Keep the communication lines between you and your partner open and discuss feelings throughout the entire process
Did endometriosis cause infertility issues for you? How has that impacted your life?
Find Endometriosis Specialists for the Best Possible Outcomes
Why You Need an OB-GYN Who Specializes in Endometriosis
Endometriosis is common (affecting nearly 190 million women worldwide) but poorly understood by many medical professionals. It’s hard to find endometriosis specialists who have completed advanced training. With the proper endo specialist, medical treatment or surgery can lessen your pain, improve your quality of life, and manage complications.
Endometriosis is a chronic pain condition that affects 10-15% of women of reproductive age. It causes painful periods, bleeding between periods, pain during sexual intercourse, and discomfort when passing urine or feces. Despite causing chronic pelvic pain, many medical professionals have a poor understanding of the condition.
In this article, we will look into what endometriosis is and explore how to improve diagnosis, treatment, and outcome factors.
What is Endometriosis?
Endometriosis affects menstruating women and girls and some women post-hysterectomy or post-menopause. The condition also can affect transgender men and non-binary individuals. Endometriosis affects roughly 190 million people worldwide, with immune, genetic and hormonal factors all likely to be at play.
To understand Endometriosis, we first need to understand the endometrium or lining of the uterus.
The Endometrium
A large proportion of the endometrium is stromal cells. Stromal cells regulate cell growth and change during the menstrual cycle.
Endometrial glands line the endometrium. During the menstrual cycle, they widen in response to greater blood flow.
Each cycle, stromal cells, and endometrial glands slough off as part of menstruation.
Endometriosis Lesions
The presence of endometrium-like cells found outside the uterus causes the classic endometriosis symptoms. Discourse exists, but scientists have concluded a genetic basis to the cells’ presence, with endometrium-like cells migrating inappropriately during embryogenesis.
Endometriotic lesions can be in the ovaries, uterine ligaments, fallopian tubes, and pouch of Douglas (the space between the uterus and rectum). In some, lesions are present outside the pelvic cavity. Locations include the bowel, urinary tract wall, diaphragm, lungs, abdomen, and pericardium (the sack around the heart).
The endometrial-like tissue responds to the natural cycle of hormones and also produces some hormones by itself. This tissue has cycles of growth and bleeding.
Whereas menstrual blood in the uterus leaves the body via the vagina, the blood and tissues cannot escape from endometriosis lesions. This trapped cells and tissue leads to the painful processes of inflammation, adhesions, and scarring.
What does it feel like to have Endometriosis?
Although pain is the most common complaint, Endometriosis causes a wide range of symptoms, including:
- Painful periods
- Heavy periods (menorrhagia)
- Vaginal bleeding between periods
- Pain on passing urine or feces
- Bowel symptoms include bloating, constipation, diarrhea, or bleeding from the bowel
- Pain during intercourse
- Tiredness
- Depression
- Infertility.
Social and Emotional Effects
Severe pain can interrupt daily life for many patients. This interruption may include missing school, taking days off work, or being unable to socialize. A study in 2020 found that in over half of women, the pain had reduced their professional, physical, and sexual activity.
Endometriosis is associated with low mood. 15% of women are diagnosed with depression, with an average age at diagnosis of 22.
Infertility
Infertility can be the only symptom of Endometriosis for some women. Around 30-50% of patients cannot get pregnant owing to inflammation, pelvic adhesions, blockage of the fallopian tubes, and changes to the pelvic anatomy.
Other Symptoms
Additional symptoms are dependent on the location of endometriosis lesions. For example, an endometriotic lesion in the lung could cause breathlessness or chest pain. A study of over 2000 patients found that endometriotic nodules caused leg and buttock pain, as well as numbness, similar to sciatic pain.
Misdiagnosis and incorrect management are therefore common for women with symptoms that are not classic to pelvic endometriotic lesions.
Endometriosis Myths
The average delay in the diagnosis of Endometriosis is more than seven years, leading to “unnecessary suffering and reduced quality of life.” This delay leads many people to the internet to conduct their own research before and during diagnosis. However, the internet is awash with myths.
The importance of educating yourself via a reputable source such as iCareBetter cannot be understated.
Find Endometriosis Specialists for Appropriate Diagnosis & Treatment
The widespread misunderstanding of Endometriosis hinders its diagnosis and treatment. The inappropriate investigation, treatment with analgesics, or hormonal suppression do little to manage the cause while delaying diagnosis. Women who felt they were not listened to nor understood by doctors have described frustration, anger, annoyance, and sadness.
Reassuringly, appropriate diagnosis and treatment can lead to significant improvements in pain. This is precisely why it is crucial to find an endometriosis specialist. Only highly specialized surgeons with a comprehensive team can perform a thorough excision to remove endometriotic lesions, including extra-pelvic locations. Complete removal can significantly improve overall outcomes, including relief from pain and increased quality of life.
iCareBetter Endometriosis Care
iCareBetter is a platform that connects patients with experts in endometriosis care. At iCareBetter, patients have access to surgeons who have completed advanced training. These professionals have shown expertise in the diagnosis and treatment of complex Endometriosis. iCareBetter utilizes a transparent and unbiased system to ensure that only doctors with proven advanced excision skills and a comprehensive care team can be on their surgeons’ list.
Patients can select their surgeon based on their specific symptoms. This empowers patients to consult a doctor who truly understands the complexity of their condition. Patients can access specialists for endometriosis in the pelvis, bowels, bladder, thorax, heart, or diaphragm. They also can find help with infertility issues.
A highly specialized endo surgeon will take a holistic approach to treatment. This holistic approach includes managing secondary comorbidities such as infertility, even in stage III and IV disease patients.
At iCareBetter, patients can also access expert physical therapists who understand the condition. Working with a physical therapist gives access to myofascial release techniques, visceral mobilization, and the tools to manage a susceptible nervous system for better pain management.
Team-based expert care improves post-operative outcomes. For some iCareBetter doctors, post-treatment reports of satisfactory pain relief could be over 80%, with less than 20% of women requiring subsequent pelvic surgery. Moreover, many patients see reduced pain relief requirements post-recovery.
Standards of excellence, such as those endorsed by iCareBetter, must become a driving force behind treatment protocols for Endometriosis. Women should no longer shoulder the pain and reduced quality of life associated with substandard care.
Conclusion
Endometriosis occurs due to the presence of endometrium-like cells found outside the uterus. The resulting inflammation, adhesions, and scarring can cause severe pain and symptoms related to the location of the lesions. By connecting patients with expert surgeons in endometriosis care, iCareBetter empowers patients to access the care leading to better outcomes. Advanced surgical excision, physical therapy, and an expert team-based approach can reduce pain, as well as skillfully manage secondary complications.
Find endometriosis specialists today.
7 Ways to Prepare For First Endometriosis Specialist Appointment
Diagnosis. Treatment. Surgery. Many Topics May Be Discussed At Your Visit
An endometriosis specialist appointment is not something you do every day (although sometimes it might feel like all day while you’re waiting there). However, the time you get to talk with the doctor may be pretty short. During that moment of consultation with the endometriosis (endo) specialist, you might feel brain fogged or bombarded. Whether it’s the diagnosis, treatment, surgery, pain management, or an endometriosis symptom you want to bring up, it’s easy to forget an essential topic while you’re there.
To make the most out of your initial endometriosis specialist appointment with an endometriosis specialist, we’ve made a list of seven ways you can prepare for the visit. First, we will give a short description of what endometriosis is.
Table of contents
7 Ways to Prepare for Endometriosis Specialist Appointment
Endometriosis Care Process with iCareBetter
What’s Endometriosis?
Endometriosis is a female medical disorder in which tissue similar to the endometrium (tissue that lines the walls of the uterus) grows outside the uterus. This endometriosis tissue can grow on the surface of the uterus, ovaries, intestines, fallopian tubes, bladder, or other organs in the body.
During menstruation, this tissue releases blood, and it sloughs off. However, this blood and tissue often remain trapped with no way to escape the body. This increased pressure can result in moderate to severe pain, among other symptoms. If you want to learn more about endometriosis and get a general background on the condition, read our article, “Endometriosis 101: Covering the Basics.”
Why You Are Here
People of various ages and demographics are subject to this often debilitating inflammatory pelvic disorder. Whether you have confirmed the diagnosis of endometriosis or if you need surgery to verify its presence and remove lesions – these suggestions can help you prepare for the endometriosis specialist appointment. There are many stages of endometriosis. Whether you’ve got into a specialist early on your journey or later, the important thing is that you are here now – exploring treatment options.
7 Ways to Prepare for Endometriosis Specialist Appointment
Once you have found an experienced endometriosis specialist, it’s essential to prepare yourself for the doctor’s appointment ahead of time. There is no concrete test to diagnose endometriosis (outside of surgery). Therefore, it’s imperative to have a solid understanding of the signs and symptoms of endo and detailed accounts of your own experience ready. Simple things such as medical records or journals that list all your endometriosis symptoms are a vital arsenal that will help you and your doctor determine your treatment plan.
1. Gather Your Records.
Unfortunately, most people with endometriosis have had many doctor appointments before seeing an endometriosis specialist. Therefore, you should have some medical records for them to review during your first appointment with an endo specialist. Gather everything from your regular medical history from your general practitioner to your OB/GYN records, testing, imaging, blood work, etc. Even if you think the particular doctor appointment or medical history is insignificant, you might be surprised by the various conditions linked to endometriosis. Bring it all. This information could play a vital role in your endometriosis treatment.
2. Keep a Journal of Endometriosis Symptoms/Pain.
Write down all the possible endo signs and symptoms you’ve had leading up to the doctor’s appointment. If you get a visit scheduled, and it’s a couple of weeks out, start the journal at that time, but also include the signs and symptoms you’ve experienced leading up to that point. Then, from that date until your appointment, write down all the different types of symptoms you experience. Include everything, even if you don’t think it’s relevant, like colds, headaches, stomach issues, shortness of breath, chest pain, etc. Also, be sure to include your emotions and feelings because endometriosis can significantly impact mental health and can lead to conditions such as depression and anxiety. Emotions and mental health are essential as you might want to include a counselor as part of your holistic endometriosis treatment team.
3. Bring This Printable Guide.
At endometriosis.org, they’ve created a convenient guide that can help you describe your symptoms and know what to ask your endometriosis specialist. Click here for the PDF. Please print it out and answer all the questions. Bring this with you to your doctor’s appointment to help specifically describe your endometriosis pain and other symptoms.
4. Take All Your Medications With You.
The importance of this cannot be understated. Even if you have a medication reconciliation (also known as a “med rec” for short) from your doctor, it’s important to realize those are not always up-to-date with everything you take. This inconsistency is especially true if you are on medications from multiple specialists or take supplements as well. The best way for your endo specialist to have a complete picture of all the medicines you are currently taking is by bringing them with you to the doctor’s appointment. You should include any supplements or over-the-counter medications. Bring in the physical bottles along with any medication history records.
5. Prepare Yourself Mentally.
Go into the appointment with the bold mindset that you will ask every single question you have to gain clarity on your endometriosis diagnosis and treatment options. Endometriosis is an aggressive inflammatory disorder that can have a devastating impact on your quality of life. It would help if you carried an even more aggressive attitude toward trying to stop it dead in its tracks.
6. Bring a List of Questions.
What’s been bothering you the most? Pain? Bowel symptoms? Bring a list of all the important questions that you want answers to. Writing them down will help you not forget during the appointment. Furthermore, when the doctor sees you have a list of questions you want answers to, it makes it harder for them to get up and walk out of the room like the appointment is over. If something like that has ever happened to you, we are sorry you’ve experienced this. That’s why it’s crucial to find a vetted endometriosis expert.
7. Take a Support Person With You.
Finding a good endo expert is no easy task (unless you use iCareBetter to connect you to one). If you are the type of person who is a bit shy or feels intimidated, you should bring your best support person to the appointment with you. Even if you are not nervous about your first endometriosis specialist appointment, having someone you trust by your side can help you process the information and encourage you along your journey. If no one you would like to accompany you, consider bringing a recorder and taping the visit. Because this can help you go back later and make sure you’ve understood all the information. Most doctors will have no qualms about recording your visit.
Endometriosis Care Process with iCareBetter
1- Find an expert based on keyword/ specialty or state
2- choose your doctor from the list
3- Get the contact info
4- First call and consultation.
5- Get info regarding costs and care process
6- Receive care
We Want to Hear From You
Have you been to an endometriosis specialist (OB-GYN experienced in endo)? If so, is there anything you wished you would have done differently? If you’ve not been to an endo specialist yet, what is your biggest concern about the first doctor visit?
Find an Endometriosis Specialist Doctor for Diagnosis, Treatment, & Surgery
Why It’s Important Your OB-GYN Specializes in Endometriosis?
When it comes to the treatment and management of endometriosis pain and/or other symptoms, all doctors are not the same. In fact, if you have or suspect you might have endometriosis, you should never just walk into the office of a random obstetrics/gynecology (OB-GYN) surgeon.
However, it can be a bit tricky to find an endometriosis specialist that is highly skilled and follows the best treatment practices for this disorder. If you want to learn more about endometriosis, read this article that gives an introduction to the condition, signs and symptoms, causes, complications, and treatments.
With so many myths about endometriosis (endo) – it’s important to separate facts from fiction. Arm yourself with research and a solid foundation of knowledge to help you simplify the process and to get in touch with a trusted endometriosis specialist. Keep reading to find out why it’s so important to use an endo expert, red flags that your doctor/surgeon is not the right fit, and how to find an endometriosis specialist near you.
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This article will cover:
- What is an Endometriosis Specialist?
- How are Endo Specialists Different than Typical Gynecologists?
- The Role of Endometriosis Specialists in Treatment
- Finding the Right Doctor for Endometriosis Treatment
- Considerations When Looking for an Endometriosis Specialist
- Red Flags About a Potential Endometriosis “Expert”
- How Can I Find an Endometriosis Specialist Near Me?
What is an Endometriosis Specialist ?
Doctors with extensive experience in treating and caring for patients with this condition are known as endometriosis specialists. They are typically obstetricians and gynecologists (OB/GYNs), which are doctors who treat female pelvic organs, reproductive issues, and deliver babies. Therefore, most endometriosis specialist are also skilled surgeons.
Read more: 7 Ways to Prepare For First Endometriosis Specialist Appointment
How are Endometriosis Specialist Different than Typical Gynecologists ?
Practitioners who specialize in endo care mostly for patients with endometriosis. From surgical treatment to medical management, their guidance is unparalleled to that of a gynecologist who serves general patients. You find endometriosis specialist at large teaching hospitals, medical centers, and private practices with gynecological surgeons.
The Role of Endometriosis Excision Specialist in Treatment
The right specialist will have extensive knowledge of this disorder and the additional surgical training and skills it takes to effectively treat endo and the related conditions. Furthermore, the endo doctor should also have experience with modern techniques and access to state-of-the-art equipment – which often includes robotic or laparoscopic surgical tools. Additionally, openness to complementary treatments and a thorough understanding of various treatments are some other advantages of choosing an endometriosis expert and not just a regular OBGYN.
Patients report the most important thing about a surgeon is that they take their time and carefully listen to you. A good surgeon will pay attention when you speak and not challenge your knowledge or experience.
Read more: Common endometriosis symptoms
Uncommon symptoms of endometriosis
Finding the Right Doctors Who Specialize in Endometriosis
Endometriosis is a painful disorder that affects up to 10% of women. It is caused by cells similar to those in the lining of the uterus growing outside of it, leading to pain and other symptoms such as fatigue, heavy menstrual cycles, and infertility. As endometriosis can be challenging to diagnose and treat, finding the right doctor for your condition is essential for successful treatment. When selecting a doctor for endometriosis treatment, let’s look at what you should consider.
Types of Doctors
When looking for a doctor to treat your endometriosis, consider seeing an experienced OB-GYN or a Reproductive Endocrinologist (RE) specializing in treating fertility problems. An expert OB-GYN can provide surgical options, general care for your reproductive health, and address any issues related to your pain. They may also be able to refer you to an RE if they believe further testing or treatments are necessary.
An RE specializes in diagnosing and treating difficulties with fertility, including endometriosis. They have received specialized training in reproductive medicine, making them uniquely qualified to diagnose and treat endometriosis. Seeing an RE may help you get a more accurate diagnosis and provide access to treatments such as hormone therapy or surgery that can relieve the symptoms of endometriosis and achieve fertility.
Qualities To Look For
When selecting a doctor for endometriosis treatment, there are certain qualities that you should look for to ensure that you are getting the best care possible. Your doctor should have experience treating endometriosis, understand the physical and psychological aspects of living with this condition, and provide comprehensive care from diagnosis through treatment options and follow-up visits.
Choosing the right doctor for your endometriosis treatment is essential for successfully managing this chronic disorder. When selecting a physician, make sure they have experience treating this condition and understand both its physical and psychological components so they can provide comprehensive care from diagnosis through follow-up visits. By doing so, you can ensure that you receive appropriate care explicitly tailored to your needs and get relief from your symptoms to lead a healthier life.
Considerations When Looking for an Endometriosis Specialist
Your endometriosis specialist will be a teammate with the common goal of getting you to living your best life. Ask a lot of questions and listen to the answers. Here are some considerations when looking for an endometriosis expert near you:
- Does the doctor have experience with various medical conditions related to endometriosis?
- Does the doctor specialize in the treatment of adult or adolescent endometriosis? Or both?
- Is the doctor receptive to your information and input? What is their attitude towards your healthcare treatment?
- Does the doctor rush you through assessments and questions, or do they take their time?
- Does the doctor speak to you in terms you understand? (This is particularly important during the explanation of tests and/or surgical procedures.)
- What is the doctor’s belief on the use of hormonal therapies? Do they have medical justifications for prescribing them? Can they tell you the pros and cons of these options?
- Do you feel comfortable speaking with the doctor? Endometriosis pain and symptoms can be hard to discuss, so it’s important you feel at ease.
- Does the doctor work in cooperation with other professionals to offer holistic treatment, (i.e. physical therapists, pain specialists, psychotherapists, gastroenterologists, etc.)?
Red Flags About a Potential Endometriosis Expert
It’s important that you pick an expert who knows what they’re doing to support you. Unfortunately, there are a lot of myths surrounding surgical best practices when it comes to endo treatment. What’s even worse is that some of these options could result in infertility or other issues, and not even address the underlying endometriosis condition.
The following are red flags that could indicate the doctor you are speaking with is not a trusted endometriosis specialist:
Red Flags
- If the doctor views hysterectomy as a definitive treatment. Caution any doctor who says removing your uterus/ovaries will cure you. While this may be the correct course for some patients, it’s not a cure-all solution as endo lesions can affect other body parts and endo tissue could continue to grow.
- If the doctor says endo symptoms will go away with menopause. In medically, naturally, and surgically-induced menopause – there are women who have endometriosis afterward.
- If the doctor says mild stages of endometriosis won’t cause infertility. This is just false. “Mild” or “minimal” stages of endo can still produce significant symptoms, including those that impact fertility.
- If the doctor says that negative tests rule out an endo diagnosis. Tests such as labs, ultrasound, or magnetic resonance imaging (MRI) can help with diagnosing and staging endometriosis, but they cannot rule it out. Technology has advanced, and transvaginal ultrasound can help in assessing and staging endometriosis, however, it cannot rule out the diagnosis. Same is true for MRIs and laboratory studies.
- Hormone therapy will cure endometriosis. Studies show that hormonal medications can help temporarily reduce endometrial lesions, but they do not cure the disease.
- If the doctor suggests that recurring endometriosis cannot be treated.
- If the doctor tells you that you are too young to have endometriosis. This belief is completely false. In fact, there are adolescents who had chronic pelvic pain that were diagnosed with deep infiltrating endometriosis (DIE).
- If the doctor suggests it’s only irritating bowel syndrome (IBS). Many symptoms of endometriosis and IBS overlap. As such, this is often a misdiagnosis given to people who in fact are suffering from endometriosis. Please notice that this doesn’t mean that the patient doesn’t also have IBS in conjunction with endo.
How Can I Find an Endometriosis Specialist Near Me ?
Now that you’ve read more about the importance and what to look for in an endometriosis specialist, are you ready to connect with someone in your area? At iCareBetter, our passion is to connect patients with vetted endo specialists. Go to the directory to learn how we can help you get on the road to health and improve your quality of life.
Top Endometriosis Specialist and Doctor
Endometriosis specialist New York
Endometriosis specialist California
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Endometriosis Care Process with iCareBetter
1- Find an expert based on keyword/ specialty or state
2- choose your doctor from the list
3- Get the contact info
4- First call and consultation.
5- Get info regarding costs and care process
6- Receive care
