Endometriosis is a female disease in which endometrial-like tissue is found outside of the uterus. Endometriosis lesions are characterized as estrogen-dependent, benign, inflammatory, stem-cell driven and at times progressive with diffuse fibrosis, deep infiltration, and resistance to apoptosis (cell death) and progesterone. This tissue, which normally lines the uterus, is associated with monthly menstruation and is often characterized by abnormal painful and heavy periods, as well as pelvic pain, severe cramps, and pain with sex (dyspareunia).
Endometriosis is a painful reproductive disorder that affects an estimated 176 million women worldwide . The economic impact of the disease is staggering: Businesses lose billions of dollars each year in lost productivity and work time because of the disease. A leading cause of infertility and chronic pelvic pain, it has also been linked to other health concerns, including certain autoimmune diseases, fibroids, adenomyosis, interstitial cystitis, and even certain cancers. It is also one of the leading reasons for laparoscopic surgery and hysterectomy in the United States.
Where does it occur in the body?
Typical: It typically develops on the pelvic structures including the ovaries, fallopian tubes, bladder and bowels (intestines).
Common: It is common for the disease to develop on the top of the vagina (anterior cul-de-sac) and in the peritoneal cavity between the rectum and the posterior wall of the uterus (posterior cul-de-sac).
Rare: The disease can spread to the diaphragm, lungs, kidney, appendix, and, surprisingly, the gastrocnemius (calf muscles).
What are the stages?
American Society of Reproductive Medicine Severity Classifications
What are the Descriptive Classifications?
Because the four stages of the disease do not have any correlation to a patient’s symptoms or the nature of the infiltration itself, we often use a more descriptive system:
Painful menstrual cramps (dysmenorrhea or "killer cramps")
Heavy menstrual bleeding (menorrhagia)
Chronic pelvic pain
Pain upon intercourse (dyspareunia)
Abdomen pain and bowel dysfunction that includes painful bowel movements, diarrhea, bloating, gassiness or cramps
Bladder dysfunction, such as painful urination
Weakness, numbness or pain in nerves (neuropathy)
Personality changes (depression, stress, apathy)
What is the first step needed in order to diagnose?
Before any imaging is done, you should speak with a GYN physician who is familiar with diagnosing endo and can provide a full comprehensive pelvic exam. Between the physical exam and informing them of your symptoms and past medical history, a physician will have a better understanding if imaging tests are needed.
What are the imaging tests used to identify?
In order to properly diagnose a patient with endo, one or multiple of the following imaging tests must be conducted in order to ensure that a patient is in need of surgery:
What imaging tests help definitively diagnose endometriosis during surgery?
While in an operating room, a well-trained and experienced GYN surgeon will be able to visualize any anatomical abnormalities or endometriosis lesions through the following tests:
How is it detected?
While a physical exam and other imaging tests can give insight into whether or not a patient may have endo, the only way to definitively diagnose endometriosis is through laparoscopic excision surgery. This must be accompanied by a biopsy sample that is sent to pathology in order to confirm a diagnosis of the disease.
What are the treatments?
There is currently no cure for endo but there are surgical and non-surgical treatment options for pain and infertility related to the disease.
What are non-surgical ways that can relieve symptoms?
It is important to note that the following methods are not treatments of the disease itself, but rather a means to control a patient’s pain and symptoms. They provide a relief, not a cure.
What surgical procedures can be performed during surgery?
There are a variety of surgical treatments that a patient can undergo to treat endo depending on the severity, stage, and abundance of the endometrioma lesions.
As a patient, your health and wellbeing come first. Having had decades of experience, we know that this is the most important aspect in treating the disease. Every patient is different and therefore every patient must be heard.
Menoka M. was experiencing severe pelvic pain for the past seven years and was not diagnosed with endo for nearly five years. After seeing many doctors and having several surgeries, Menoka found us and was soon scheduled for laparoscopic deep excision surgery. Read about Menoka's journey here, as well as how she is doing now.
You can read more stories of patients with endo, of varying stages, in our testimonial section.
Our office is located on 872 Fifth Avenue New York, NY 10065. You may call us at (646) 960-3080 or have your case reviewed by clicking here.
After years of excessively painful periods, a serious loss of quality of life, and a series of uninformed and uninterested doctors, Dr. Seckin and Dr. Goldstein turned my life around. I was told I woke up from my surgery almost a year ago with a smile on my face, and I haven't stopped since. Before I heard of Dr. Seckin,…
Dr Seckin and his team gave me back my life! Tomorrow will be 1 month since my surgery and I feel great. Dr. Seckin, Dr Liu, and Dr Goldstein are not only beyond words talented and amazing Doctors, but they are also genuinely wonderful and caring people. I cannot say enough great things about Holly, Asiye and Kim as well.…
Dr. Seckin and his staff spared me from years and years of heavy periods and unbearable endometriosis pain. After having surgery with him (my first) I can now function like a regular human. No more eating NSAIDs like candy and calling out sick from work. Thank you, Dr. Seckin!
I underwent surgery with Dr. Seckin in 2017 and have felt like a new woman ever since. If you have, or suspect you have endometriosis, Dr. Seckin and his compassionate team of surgeons and staff are a must-see.
I have struggled with endometriosis and adenomyosis since first starting my period at 13. I was diagnosed at 21 and what followed was a series of unsuccessful surgeries and treatments. My case was very aggressive and involved my urinary tract system and my intestines. After exhausting all of my local doctors I was lucky enough to find Dr. Seckin. We…
Like so many women who have tirelessly sought a correct diagnosis and proper, thorough medical treatment for endometriosis, I found myself 26 years into this unwanted journey without clear answers or help from four previous gynecological doctors and two emergency laparoscopic surgeries. I desperately wanted to avoid the ER again; a CT scan for appendicitis also revealed a likely endometrioma…