Endometriosis: silent suffering brought to light

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Endometriosis was a little-discussed medical condition just a few years ago. But celebrities like Julianne Hough, Lena Dunham and the singer-songwriter Halsey sharing their personal experiences with endometriosis has made it easier for many other women who have secretly dealt with this common health problem to come forward.

According to the Office on Women’s Health, a part of the U.S. Department of Health and Human Services, about 11 percent of American women between the ages of 15 and 44 have endometriosis.

Jennifer Knudston, M.D., reproductive endocrinologist and fertility specialist at UT Health San Antonio, says endometriosis occurs when the blood and tissue that is supposed to make its way out of a woman’s system during her menstrual cycle instead ends up going through the fallopian tubes and into the abdominal cavity.

“For whatever reason in some women” Dr. Knudston said, “the tissue sticks in places it shouldn’t stick. It sticks to the abdominal lining, the ovaries and the fallopian tubes, causing lots of pain.”

Although painful periods are the number one cause of clinical suspicion for diagnosis, they are not always caused by endometriosis. It can be an ovarian cyst or another underlying issue. “Unfortunately, the only way we can say for sure a patient has endometriosis is surgery,” Dr. Knudston said.

Surgery may be intimidating for many, but Dr. Knudston is concerned by frequent delays in diagnosis because women have normalized their painful periods. “The average delay is 8-10 years of women saying, ‘I have had the most painful periods, but I just thought this was normal and who I was’.”

Every patient is different, and endometriosis affects bodies differently, which means treatment is very personalized.

“Some women may be more concerned with pain management while another patient is concerned with fertility,” said Dr. Knudston.

Dr. Knudston and the rest of the Obstetrics and Gynecology (OBGYN) team at UT Health Physicians offer individualized treatment plans for each patient’s goals as well as multi-disciplinary care that includes physical therapy and fertility treatments.

If you suspect you have endometriosis, talk to your physician. Dr. Knudston encourages women to start the conversation.

“The first step is just to talk about it. Sometimes we don’t want to talk about periods, but it is OK. We are here to help.”

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