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Endometriosis happens when tissue normally found inside the uterus grows in other parts of the body. It may attach to the ovaries, fallopian tubes, the exterior of the uterus, the bowel, or other internal parts. As hormones change during the menstrual cycle, this tissue breaks down and may cause painful adhesions, or scar tissue. More than 5.5 million American women have symptoms of endometriosis.

Consider these statistics:

  • An estimated 176 million women worldwide suffer with endometriosis, according to an article in the Journal of Endometriosis and Pelvic Pain Disorders.ii
  • Thediseasetakes,onaverage,nearlytwelveyearstodiagnoseintheUnit- ed States and roughly eight years to diagnose in the United Kingdom, according to a survey published in the journal HumanReproduction.iii
  • The American Society for Reproductive Medicine says endometriosis can be found in up to 50 percent of infertilewomen.iv
  • AnarticleinHumanReproductionstatesthatdirecthealthcarecostsofen- dometriosis and indirect costs of time lost from work due to endometri- osis amount to an estimated $110 billion annually in the UnitedStates.v
  • According to a recent Finnish study that appeared in the Journal of Pedi- atric & Adolescent Gynecology, one-third of girls ages fifteen to nineteen were found to suffer severe menstrual pain, of which 14 percent were consequently regularly absent from school orhobbies.vi

 

Numerous women have endometriosis but don’t know they have it. And those who do know they have it often don’t talk about it.

Why the silence?

Several reasons.
There’s the taboo that still exists against anything involving a woman’s menstrual period; the exhaustion of being repeated- ly misdiagnosed; the stigma of always being sick—the list goes on, and it will be discussed in greater detail in subsequent chapters.
So what is endometriosis? My description will be simple and com- prehensive, so much so that any person, even those who are ignorant about how the female body works, will understand it.
Endometriosis is defined as the presence of endometrial-like tissue outside of the uterine cavity. By “endometrial-like tissue,” I mean tissue that greatly resembles the endometrium, which is the interior lining of the uterus that grows every month to prepare the uterus for the implanta- tion of a fertilized egg. Endometriosis causes pelvic pain in reproductive
-age women and adolescent girls and is associated with heavy menstrual periods, clotted flow, gastrointestinal symptoms, fertility problems, and a tremendous loss of quality of life.
Throughout the ancient and modern history of endometriosis, doc- tors and researchers have had different theories and opinions as to what causes it. Just recently we learned that endometriosis can be present at birth; it was found in some newborn fetal autopsies and was attributed to the fetuses’ exposure to elevated levels of maternal pregnancy hormones, namely estrogens and progesterones. The belief is that although a female may have endometriosis at birth, it doesn’t activate until her first men- strual period. I believe the disease can be inherited, as you will read about in the chapter on genetics. Many also believe, that the disease can be caused by retrograde menstruation. While this is a controversial view, my thirty years of clinical observation suggests that retrograde menstruation must play a triggering role in the development of endometriosis, par- ticularly through the gene material in the stem cells. It is likely that the disease may actually occur differently in different women, allowing for multiple hypotheses, which is why I offer the opinion of Dr. Harry Reich in Chapter 39. Research investigations have yet to provide clear answers. “Retrograde” means “moving backward.” Retrograde menstruation refers to a woman’s menstrual blood flowing back into her body during her period. Let me explain further. Ovulation—the hatching of eggs from the ovaries—occurs in a woman’s body each month. Fourteen days later, if there is no pregnancy, she has her menstrual period, during which her body naturally sheds the endometrium. If the menstrual flow proper- ly exits from her body, the flow carries the endometrium with it through the cervix, the opening of the uterus that connects to the vagina. The cervix is small, strong, and tight; it opens to allow menstrual blood out, but it also keeps a baby in the uterus for nine months. When the labor starts, uterine contractions dilate the cervix to allow the baby into the
vaginal canal for the birthing process.
If the menstrual flow does not exit as it should, the menstrual blood may leak back into the body through the natural openings in the fallopian tubes. Where does menstrual blood go? It implants in areas outside of the uterus in the pelvis and creates an abnormal growth of cells: endometriosis cells with inflammation. That’s not a good thing, and it may get worse. The body’s immune system desperately and futilely tries to eliminate these dis- located cells, which results in deeper inflammation with new blood vessels and stem cell activity resulting in deep and thick scar tissue. As a woman’s hormones (estrogen and progesterone) change during her menstrual cycle, the implants (which are also called lesions or nodules) respond to the hormonal fluctuations by growing. In other words, estrogen and progesterone are feeding the beast, serving as food for the implants. Unfortunately, unlike the endometrium that naturally leaves the body, there is no way for the implants to exit the body, so the inflammation continues.
This is endometriosis—menstrual periods that are literally stuck in- side of a woman’s body. The implants can grow deep and wide, spreading and clinging to her uterus, appendix, rectum, ovaries, intestines, leg nerves, and other parts of the pelvic region. They are like leeches that attach to, reproduce on, and grow on whatever internal organs they find. They are similar to a slow-growing cancer that invades the organs in the pelvis. In some rare cases, they can spread to the diaphragm, lungs, kid- neys, or brain.
The disease always causes inflammation, which can lead to adhe- sions, scarring, internal bleeding, bowel or urinary dysfunction, consti- pation, painful intercourse, and infertility. The physical pain can be un- bearable, which inevitably leads to psychological pain. A woman’s career may suffer. Relationships with loved ones may become strained. She may have to miss a lot of school, or even drop out. This disease threatens to become a woman’s identity, ruling every phase of her life.
Endometriosis, however, is a treatable disease. Some of my patients say that the deep-excision surgery I performed on them “cured” them. Although they may feel as though they are cured—because I was able to remove all their endometriosis and, as a result, transform their lives to the extent that they are pain-free and happier than they have been in many years—there is no guarantee that the disease won’t return at some point. The hope is that it won’t, but it could. Endometriosis is not like a bacterium you can eradicate with antibiotics or a virus you can prevent with immunization. It’s something that can continue to happen to some women’s bodies throughout their lives, and it needs to be recognized, diagnosed, and eradicated by excisional removal each time.
Whether one believes that the disease is curable or incurable, it is at the very least treatable through deep-excision surgery, and many women who undergo the surgery can reclaim their lives and live pain-free, which is a significant advancement from days of old.

Our office is located on 872 Fifth Avenue New York, NY 10065.
You may call us at 646-960-3040 or have your case reviewed by clicking here.

 

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Patient Reviews

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  • Angela Aro

    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…

  • Emi O

    Seckin and Dr. Goldstein changed my life!

  • Kristin Sands

    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…

  • Wilfredo Reyes

    Dr. Seckin literally gave my wife her life back. I am eternally grateful to him for his generous, determined spirit to see that Melanie finally live free from the prison bonds of Endometriosis.

  • Carla

    I am so grateful to Dr Seckin and Dr. Goldstein. My experience was nothing short of amazing. I was misdiagnosed with the location of my fibroids and have had a history of endometriosis. Dr. Seckin was the one who accurately diagnosed me. Dr Seckin and Dr. Goldstein really care about their patients and it shows. They listened to my concerns,…

  • Melissa Boudreau

    When I think of Dr. Seckin these are the words that come to mind. Gratitude, grateful, life-changing, a heart of gold. I feel compelled to give you a bit of background so you can understand the significance of this surgery for me. I am passionate about Endometriosis because it has affected me most of my life and I have a…

  • Jaclyn Harte

    Dr. Seckin and Dr. Goldstein radically changed my quality of life. They treat their patients with dignity & respect that I've personally never seen in the literally 25+ doctors I've seen for endometriosis. This summer, I had a surgery with Dr. Seckin & Goldstein. It was my first with them, but my 5th endo surgery. I couldn't believe the difference,…

  • Megan Rafael Moreno

    I was in pain for 2 years. I was getting no answers, and because dr Goldstein and dr seckins were willing to see and treat me I'm finally feeling almost back to normal. They were very down to earth and helpful in my time of need. Dr Goldstein was easy to talk to and caring, she took care of me…

  • Nancy Costa

    Dr. Seckin is one of the best endometriosis surgeon. Every time I go to the office, he really listens to me and is always concerned about my issues. Dr Seckin's office staff are a delight and they always work with me. I feel I can leave everything to them and they will take care of it. Thank you to the…

  • 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…