ORLANDO, Fla. (Ivanhoe Newswire) — Endometriosis affects about one out of every ten women in the United States. But the disease is often misdiagnosed or missed altogether. Now, new European guidelines could help doctors identify it earlier.
Susie Veech was living with heavy periods and painful cramping for more than eight years and she didn’t trust what doctors told her. Doctor’s told her, “They’re just ovarian cysts, we can’t do anything.”
Finally, Susie found a doctor who correctly diagnosed her with endometriosis – a condition that happens when tissue similar to the lining of a woman’s uterus grows outside the uterus. Doctors typically use special laparoscopic instruments to look inside the patient and spot the disease – but cases that aren’t “classic” may be overlooked.
“There are many, many other types, and they are not as obvious. So, that is actually one of the things that we are trying to improve upon is detection rates.” Says Kevin Audlin, MD, FACOG, Gynecologist at Mercy Medical Center.
Now, scientists in Europe have proposed new guidelines that could improve those detection rates. The new recommendations support imaging techniques like ultrasound and MRI for diagnosis in some cases instead of only laparoscopy. Experts say diagnosing it without the need for a procedure like laparoscopy every time could lead to a quicker diagnosis and treatment plan. Something patients like Susie would appreciate.
“I think it’s really important to ask the questions and get the diagnosis and don’t give up if two or three or four doctors tell you we can’t do anything.” Veech says.
Experts say the European guidelines can act as a blueprint for endometriosis care in the US. Patients typically receive a diagnosis of endometriosis eight to 12 years after symptoms start.
Contributors to this news report include: Julie Marks, Producer; Roque Correa, Editor and Videographer
ENDOMETRIOSIS GUIDELINES FROM EUROPE
BACKGROUND: A common gynecological condition that affects an estimated 2 to 10 percent of American women of childbearing age is known as endometriosis, which comes from the word “endometrium,” the tissue that lines the uterus. Women with endometriosis develop tissue that looks and acts like endometrial tissue outside of the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity. Each month, this tissue responds to the hormonal changes of the menstrual cycle by building up and breaking down just as the endometrium does, resulting in small bleeding inside of the pelvis. This leads to inflammation, swelling, and scarring of the normal tissue. The most common sites of endometriosis include: the ovaries, fallopian tubes, ligaments that support the uterus, the posterior cul-de-sac (space between the uterus and rectum), the anterior cul-de-sac (space between the uterus and bladder), the outer surface of the uterus, and the lining of the pelvic cavity.
SIGNS AND SYMPTOMS: The primary symptom of endometriosis is pelvic pain associated with menstrual periods. Common signs and symptoms may include painful periods, pelvic pain and cramping that begins before and extends several days into a menstrual period, lower back and abdominal pain, pain during or after intercourse, pain with bowel movements or urination, excessive bleeding, infertility, and fatigue, diarrhea, constipation, bloating or nausea. The severity of the pain may not be a reliable indicator of the extent of the condition. It could be mild with severe pain, or advanced with little or no pain. Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID), or ovarian cysts. It could also be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping.
NEW RESEARCH: Researchers from Penn State, the John B. Pierce Laboratory, Yale School of Medicine, and Johns Hopkins University are exploring potential treatments and the link between endometriosis and heart disease, which are both inflammation disorders in the body. Heart disease risk in women is typically treated with estrogen, but estrogen exacerbates the symptoms of endometriosis. Endometriosis is typically treated by suppressing estrogen production in women. So, researchers examined the link between estrogen suppression and cardiovascular disease risk in women with endometriosis. “Understanding how estrogen suppression affects the function of blood vessels is a critical step to understanding how to treat endometriosis without increasing a woman’s risk of heart disease,” said Nina Stachenfeld, fellow at John B. Pierce Laboratory and senior research scientist of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine. Researchers are testing two existing drugs. One is a statin, a class of drugs typically used to lower cholesterol but are also anti-inflammatories, and the effect of a breast cancer drug known as a “selective estrogen-receptor modulator” on blood vessel function. They hope this leads to larger trials so that clinicians can treat endometriosis without an increasing risk in heart disease.
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