Endometriosis Pain Treatment

Retrograde Bleeding

Understanding endometriosis and pelvic pain starts with understanding menstrual anatomy, hormones involved in menstruation, and the neural pathways related to organs involved with endometriosis implants. Pelvic pain originates from the layer covering the organs, and their connecting structures, namely the peritoneum. Pain can also be due to the dysfunction of the organ deeply infiltrated by endometriosis. The mechanism of pain caused by endometriosis is extremely complex. Endometriosis is the most common cause of pelvic pain in women in their menstrual years, and pelvic pain is the most common symptom of endometriosis.While most women experience mild cramps, not all cramps are painful. Women with endometriosis, however, experience excessively painful cramps with menstruation that may progressively worsen in severity and duration. Cramps, or pelvic discomfort and distress, can be described as dull, sharp, stabbing, twisting, penetrating, or pulsating. In the initial implantation stages of endometriosis, before deep infiltration or invasion, the pain is nonspecific and very commonly associated with gastro-intestinal symptoms. These symptoms include nausea, vomiting, bloating, gas, fluid retention, and diarrhea. In later stages when fibrosis and nodule formation progress into invasion and infiltration, severe symptoms of constipation,  painful bowel movement, and painful intercourse may begin.

Endometriosis pain is always pelvic in location and overlaps with menstruation. Every month the uterine lining (the endometrium) sheds in the absence of conception. The endometrium consists of swollen glands and blood vessels to accommodate pregnancy. The uterus must contract to expel this debris through its opening called the cervix. A deficiency in the prostaglandins may also play a role in this process. Other factors causing incomplete and ineffective emptying of the endometrial cavity are uterine anomalies such as intrauterine septum, arcuate cavity, and rudimentary horn. When the endometrial cavity and its menstrual debris is deposited into the inner peritoneal cavity through the tubal openings, the process is called the retrograde menstruation. While most women experience this normally, the volume of menstrual debris could be excessive due to factors causing heavy periods. In young girls and adolescents, coagulopathies such as Von Villa Brand disease, thrombocytopenia, factor 8 Laden must be ruled out. Endometrial polyps, fibroids submucosal, and adenomyosis develop from uterine muscle tissue and must be considered in older women with any type abnormal uterine bleeding. Heavy menstrual bleeding with pain is called menorrhagia and dysmenorrhea respectively, and point mainly to the uterus as the source of pelvic pain.

The basic mechanism explaining the foundation of endometriosis pain is peritoneal inflammation. Therefore dysmenorrhea (painful period) is mainly due to uterine cramps, and accompanying pelvic pain is due to irritation and inflammation of the peritoneum. As the implanted lesions settle down and begin to be hormonally responsive to estrogen, the so-called foci of mini periods is trapped within the thin peritoneal layer. Monthly reoccurrence of the same inflammatory process leads to thickening and disfiguring of the peritoneum due to scar formation called fibrosis. Fibrosis sets the stage for the more advanced disease including deeply infiltrating endometriosis of the bowel, bladder, ureter, and endometrioma of the ovary. 

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.

Patient Reviews

Write a review
  • Rachel Grobman

    Dr.Seckin is so much more than a surgeon. His passion for helping endometriosis sufferers and determination to improve the quality of life in all of his patients is undeniable. I remember when my gynecologist first told me I needed a laparoscopy. Her exact words were "I can do the surgery, but if you were MY daughter- I'd send you to…

  • Esin Kocabiyik

    I was there for hysterectomy but then I found out that I also had endometriosis.My both surgeries went excellent and I feel great!.I am so thankful to Dr.Seckin and all his team for making my journey smooth!

  • Samuel Taveras

  • Rena Ebrahim

  • nikoletta pados

    I am a physician who suffered from deep infiltrative endometriosis. I needed laparoscopic surgery, so I went to see my former gynaecologist and he performed the procedure (a surgery which he supposedly does hundreds of times a year) last November. I had severe pain again when I had my period in January and was advised to go on taking a…

  • Grace Larsen

    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,…

  • Nicole Novakowski

  • Jacqueline Galindo

    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.…

  • Anna Lu

    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!