Understanding Endometriosis

UW Health gynecological surgeon Cara King says a minimally-invasive surgical approach often makes sense to treat endometriosis.Madison, Wisconsin – Many women suffer through painful periods every month—sometimes for years—not knowing why, or how to manage it. But thanks to growing awareness of endometriosis, and breakthroughs in treatment options, relief is within reach for more women than ever.


Around one in 10 women will develop endometriosis during her reproductive years. But a lot of people don't know anything about it, says UW Health gynecological surgeon Dr. Cara King.


Endometriosis is a disease in which the lining of the uterus implants outside the uterus. Inflammation and lesions can form in any number of places, including the ovaries, fallopian tubes, bowel or bladder.


"Pain is the number one thing that triggers women to see me," King says.


There are, of course, other triggers for pelvic pain, but when a woman misses work or school because of the pain that can't be managed by over-the-counter medication, it’s time for her to schedule an appointment with her doctor.


The gold standard for diagnosing endometriosis is through laparoscopy and a tissue sample. Treatment options can include suppressive medical therapy, but King says surgical excision, or removing all of the endometriosis implants, provides optimal results.


King says the exact causes of endometriosis continue to be poorly understood. Common practice has been to burn the lesions, or take tissue samples for diagnosis, but leave the underlying lesions behind.


"We’re now learning if we actually remove the entire lesion, women often do much better in the long run. They frequently have a much higher quality of life and a much lower chance of recurrence."


Recovery time depends on how many lesions are being removed, but women typically return home the same day, and are feeling back to normal in just a few weeks.


King also notes it’s important to bear in mind a woman's future fertility plans when considering more or less aggressive treatment options. If the endometriosis is caught and treated early, King says most women should be able to become pregnant with little to no complications.


Efforts to educate women about endometriosis are growing around the world, and King hopes such campaigns help all women become more aware of this disease.


"The longer women go with endometriosis, the more damage it can cause to the pelvis," she says.


Her message to women? "See your doctor early, so you can get diagnosed and treated."


There isn't a great deal of research about endometriosis, or how to treat it. And that’s part of the reason women may suffer for so long before finally finding relief. King says until recently, it took between five and 10 years on average from when a woman began to notice symptoms until diagnosis and treatment.


This is especially common in girls and young adults.


"Often, there is a delay in diagnosis because both patients, and physicians, tend to normalize the symptoms women have with their period," King says.


It’s a common misconception that endometriosis is something that affects mostly older women, she adds, but the disease can manifest any time after a girl’s first period, and into her teens and twenties.


King is one of only a few surgeons in the Midwest trained to perform a very specialized type of surgical excision that is especially effective on deeply invasive or significant endometriosis. It’s not only a newer procedure, but also part of a new thought process on the disease itself.


As a student, King fell in love with the operating room right away, and was drawn to complex cases. She focused on this specific procedure during her two-year, minimally invasive gynecological surgery fellowship, and says it’s very rewarding to help women feel like themselves again.


"I’ve seen so many women who went through many years of misdiagnosis and pain," she says. "These topics are personal, and can be embarrassing. But I want to encourage women to be educated, and not be afraid to avoid their opinions and concerns with their physician."


Date Published: 09/01/2015

News tag(s):  cara r kingobgyngynecology

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