Endometriosis: Getting the Message Out There

Although endometriosis is the most common condition identified among women with dysmenorrhea and chronic pelvic pain, its evaluation and management presents many challenges to practicing clinicians. Dr. As-Sanie emphasizes diagnostic and treatment strategies for the primary care clinician.

• Endometriosis is an estrogen hormonally stimulated condition, so it is very estrogen dependent. As for causes, family history is definitely an important risk factor.
• We know that there is a genetic predisposition, and it does tend to run in families. It’s not related to one specific gene mutation; there are multiple genetic factors that might contribute. There is suspicion that there might be some environmental factors in terms of environmental toxins, but that data is pretty murky. So we don’t give patients any specific precautions to avoid the disease.
• One of the biggest challenges in this patient population is that there’s a big delay in the diagnosis. I think that there’s a minimization of pain in women and reproductive type health issues related to pain.
• While we’re trying to do a better job of educating gynecologists I think that our target audience needs to not just be gynecologists, but needs to be pediatricians, needs to be primary health providers, needs to be nurses in high schools and in middle schools. Because these practitioners are more often than not who, when the symptoms begin in these young adolescent years, are the first to see these patients. Improving our outreach and our education to those populations of providers and patients I think could be incredibly impactful for these patients to help get them to the right doctors.
• To get them the right treatment early before the disease progresses, before it has life impacting changes that are probably worse with delays in diagnosis. But in general it’s more likely to be identified in younger reproductive age women, so in their early 20s is probably the most common age at diagnosis.