What are gynepathologies?

“Gynepathologies” are non-cancerous diseases of the female reproductive tract. They affect well over half of all women during their lifetimes.  Gynepathologies, including endometriosis, uterine fibroids, polycystic ovarian syndrome, Asherman’s syndrome, and others, involve aberrant growth of reproductive tract tissues, often leading to symptoms of debilitating pain, bleeding and infertility.

What is endometriosis?

Endometriosis is a condition that can cause chronic pelvic pain, especially at the time of menses. It is unclear exactly why endometriosis develops, but it is believed to be caused by reverse flow of menstrual blood from the womb to the abdomen through the fallopian tubes. The menstrual blood contains endometrial cells that can implant anywhere in the belly. The most common location of implantation is the peritoneum, which is a layer of tissue that lines the surface of the abdomen. These cells can also implant on the organs in the belly, such as the bowel, bladder, and ovaries. During menses, these implants can grow and become inflamed, causing significant pelvic pain. The inflammation can also cause scarring in the abdomen. This scarring may cause constant pelvic pain, as well as infertility by distorting the anatomy of the fallopian tubes and ovaries.

Although many physicians may make a presumptive diagnosis of endometriosis and begin treatment with hormones for women who present with pelvic pain with menses, women must understand that endometriosis is one of many possible causes of pelvic pain. Therefore, further investigation is necessary to pinpoint the cause of the pelvic pain; other causes of pain include fibroids, adenomyosis, ovarian cysts, intestinal problems, bladder problems, etc.

Endometriosis can only be definitively diagnosed after surgical confirmation. Lesions suspicious for endometriosis are identified and tissue samples are sent to the pathologists who ultimately confirm the diagnosis. Pathologic confirmation is necessary because although most surgeons are able to identify lesions that are suspicious for endometriosis, visual diagnosis of endometriosis is not an accurate mode of diagnosis. The appearance of endometriosis varies significantly from person to person. Here are some examples of the different types of endometriosis lesions.

How is endometriosis managed?

Endometriosis can be treated with a variety of surgical methods. If a woman has completed child-bearing, definitive surgery can be performed, which entails removal of the uterus, with or without removal of the ovaries. For women who desire future pregnancy, surgeons will eradicate just the endometriosis lesions and attempt to restore the natural anatomy of the pelvis. The lesions can be removed in a number of ways: 1) burning of the lesions with laser or other electrocautery devices and 2) resection (cutting out) of the lesions. Some lesions are superficial, just on the surface of the peritoneum, while other lesions invade deeper into the tissue, requiring more extensive dissection. The technique used to eradicate these lesions varies from physician to physician.

What is adenomyosis?

The U.S. National Library of Medicine defines adenomyosis as uterine thickening that occurs when endometrial tissue, which normally lines the uterus, moves into the outer muscular walls of the uterus.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002481/

How can I make an appointment with a doctor who treats endometriosis or adenomyosis?

For individuals in the Boston area, we recommend our clinical collaborators at Newton-Wellesley Hospital. You can call them at 617-243-5205.

https://www.nwh.org/womens-health-center/center-for-minimally-invasive-gynecologic-surgery/center-for-minimally-invasive-gynecologic-surgery

Are there other resources for those suffering with endometriosis?

The World Endometriosis Research Foundation (WERF) on Facebook

“WERF has a vision of a day when no woman is crippled by endometriosis nor prevented by the disease from having children.” With over 4000 members on Facebook, the WERF is a global charity which fosters (and funds) research in endometriosis to improve knowledge and treatments. This group allows for a safe internet dialogue between women all over the country to talk to each other about dealing with endometriosis.

Daily Strength: Endometriosis Support Group

http://www.dailystrength.org/c/Endometriosis/support-group

Daily Strength is one of the largest, most comprehensive network of people sharing their knowledge, experiences and support. On this website, women can create journals, track goals, share photos, and speak with women about their experiences on discussion boards. Expert advice from medical doctors is available as well.

Are there other organizations doing similar endometriosis research or outreach?

Endometriosis Foundation of America

http://www.endofound.org/endometriosis

MyEndometriosisTeam

https://www.myendometriosisteam.com/

MyEndometriosisTeam is a social network for women living with endometriosis, where members can interact with each other about the experience and struggles with endometriosis.

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