Endometriosis Pain Treatment

Retrograde Bleeding

Understanding endometriosis, and pelvic pain starts with understanding the menstrual anatomy and the hormones of menstruation, 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. Additionally pain also be due to dysfunction of the organ deeply infiltrated and involved by endometriosis. The mechanism of pain caused by endometriosis is extremely complex and completely not understood. 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. Those women with endometriosis, however, experience excessively painful cramps with their menstruation that may progressively worsen in severity and duration as well as heavier menstrual flow. Cramps, or pelvic discomfort and pelvic distress in sustained version, could be described as dull, or 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 are nausea, vomiting, bloating, gas, fluid retention, diarrhea. In the later stages when fibrosis and nodule formation progress into invasion and infiltration, severe symptoms of constipation, and painful bowel movement, painful intercourse.


Pain is another way of expressing sustained discomfort and along with uterine cramps, may be associated with intercourse, bowel movement, and joints. Endometriosis pain is always pelvic in location and overlap with menstruation. Uterus at the end of menstrual sustained cramps, a killer in nature, secondary to contraction of the uterus as well as heavy bleeding.


Every month the uterine lining called endometrium, sheds in the absence of conception. Endometrium consists of swollen glands and blood vessels to accommodate pregnancy. The uterus must contract to expel this debris through its opening called cervix. Uterine contractions may be laborious to dilate the cervix due to tightness and lengthiness of 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 also known as menstrual reflux or regurgitation. While most women experience this process, the volume of the menstrual debris could be excessive in the amount 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 the must be considered in women of later age with any type abnormal uterine bleeding. Heavy menstrual bleeding with pain is called menorrhagia and dysmenorrhea respectively, and point the uterus mainly as the source of pelvic pain.


Debris of the refluxed endometrial contains not only glands and intense blood vessel network but also stem cells from the junction of muscle layer and endometrium. Debris is usually dissolved and eradicated by immune system cells within the peritoneal fluid. In the case of endometriosis, however, menstrual debris survive as deposited on the peritoneal lining of the pelvis. The peritoneum has nerve endings as well as capillary blood supply that reach its surface layer. What start as intense irritation of the peritoneal surface layer eventually lead to inflammation, a battleground for the immune system cells trying to reject and eliminate the implanted deposits.


The basic mechanism explaining the foundation of endometriosis pain is the peritoneal inflammation. Therefore dysmenorrhea, painful period are mainly due to uterine cramps, 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 similar to what happens in the endometrium, 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 that is called fibrosis. It is the fibrosis that set the stage for the more advanced disease the deeply infiltrating endometriosis of the bowel, bladder, ureter, and endometrioma of the ovary. The infiltrative process into much deeper tissues of the bigger nerves, ligaments connecting to the bones of pelvis define the end stage of the endometriosis disease process called frozen pelvis.

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Patient Reviews

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  • Kim Molinaro

    Prior to meeting Dr. Seckin and reading his book, “The Doctor Will See You Now”, I knew little to nothing about endometriosis. I was led to believe that endometriosis was not a serious condition. I was told that the pain could be managed by taking the “pill”. I was told that the cysts on my ovaries were harmless. I was…

  • Rebecca Black

    Fast forward 5 years to find out incidentally I had a failing kidney. My left kidney was only functioning at 18%. During this time, I was preparing all my documents to send to Dr. Seckin to review. However, with this new information I put everything on hold and went to a urologist. After a few months, no one could figure…

  • Monique Roberts

    I'll never stop praising Dr. Seckin and his team. He literally gave me back my life.

  • Erin Brehm

    I had a wonderful experience working with Dr. Seckin and his team before, during and after my surgery. I came to Dr. Seckin having already had laparoscopic surgery for endometriosis 5 years prior, with a different surgeon. My symptoms and pain had returned, making my life truly challenging and my menstrual cycle unbearable. Dr. Seckin was quick to validate my…

  • Anita Schillhorn

    I came to Dr. Seckin after years of dealing with endometriosis and doctors who didn't fully understand the disease. He quickly ascertained what needed to be done, laid out the options along with his recommendation and gave me the time to make the right decision for me. My surgery went without a hitch and I'm healing very well. He and…

  • Nicholette Sadé

    Dr. Seckin brought me back to life! I am now 3 weeks into my recovery after my laparoscopy surgery, and I feel like a new and improved woman! Being diagnosed with Endometriosis, then 25yrs old in 2015, and discovering the severity of my case being stage 4, made me devastated. Dr. Seckin's vast knowledge of the disease, sincere empathy, and…

  • Anita Schillhorn

    I came to Dr. Seckin after years of dealing with endometriosis and doctors who didn't fully understand the disease. He quickly ascertained what needed to be done, laid out the options along with his recommendation and gave me the time to make the right decision for me. My surgery went without a hitch and I'm healing very well. He and…

  • Nicholette Sadé

    Dr. Seckin brought me back to life! I am now 3 weeks into my recovery after my laparoscopy surgery, and I feel like a new and improved woman! Being diagnosed with Endometriosis, then 25yrs old in 2015, and discovering the severity of my case being stage 4, made me devastated. Dr. Seckin's vast knowledge of the disease, sincere empathy, and…

  • Jason Curry

    My wife had her laparoscopic excision surgery to remove endometriosis with Dr. Seckin on Jan 30, 2014. She doesn't write online reviews so I'm writing this on her behalf. I accompanied her with each office visit she had. The staff--Lucy and Kim, are very friendly, warm and professional. Dr. Seckin was excellent in every capacity. He spent a lot of…

  • michele curcio

    Dr.Seckin has saved me! My quality of life has improved tremendously! I have my life back plus! I am pain free and with this struggle i had with Endo all of my life, it is incredible to be NORMAL! Ever ever ever so grateful! God bless this man!

  • A Google User

    My daughter was recently treated by Dr. Seckin for endometriosis and I feel blessed that she found Dr. Seckin. The surgery was such a different experience than the prior surgery performed by another physician. Her post operative recuperation was so much better, immediately from the recovery room to the time she was able to return to work. She has much…

  • Liz Filippelli

    He is an awesome doctor who saved my daughters life from debilitating endometriosis..she knew instantly upon awaking from surgery that she was better..that wad May and no complaints only praises for Dr. Wonderful Seckin!!

  • Karen N

    I was diagnosed with Endometriosis at 19. I saw several Endometriosis "Specialists" since then, had a few laproscopic surgeries to "remove" the endometriosis and continued to be in pain. I had a hysterectomy in 2012 and was told this would stop the pain once and for all. No such luck! Tired of spending days in bed with a heating pad, …

  • Lauren Rodriguez

    I researched and found Dr. Seckin after dealing with years of doctors who couldn't help me or refused to go the extra mile for their patients. I have to say I am truly blessed to have found such a compassionate and talented doctor. He is exquisite with everything he does, and both his team at the office and surgical team…