Delays in Diagnosing Endometriosis Can Lead to Irreversible Damage

This content is sponsored by The Center for Innovative GYN Care

The common symptoms of endometriosis often mimic other medical conditions, which can leave many women’s health professionals grasping at straws. Women who suffer from endometriosis often seek the help of multiple experts in their discovery, including OBGYNs, gastroenterologists, and general practitioners/internists. These medical professionals can address the symptoms individually (heavy bleeding, intense pelvic pain, difficulty going to the bathroom, blood in urine or stools during a woman’s menstrual cycle, pain during sex, or infertility), but it takes an endometriosis specialist to connect the dots and get to the root of the problem.

On average, it can take 10 years for a proper endometriosis diagnosis. In many cases, women experience difficult menstrual cycles starting in their teens. Dismissive attitudes regarding the levels of pain a woman must endure each month can lead to prolonged bouts of unnecessary misery. Many women do not bother seeking help, accepting monthly pain as part of the package until it affects another aspect of her life, like trying to conceive.

The combination of complex symptoms of endometriosis and normalized misconceptions of expected pain during a menstrual cycle have continued to ensure delayed diagnoses and treatment.


“Lesions develop usually in the pelvic cavity, but they have been detected in other areas of the body including the lungs and brain,” said Natalya Danilyants, MD “The periods of inflammation initially coincide with a woman’s period. As the disease progresses, inflammation can occur at times other than a woman’s menstrual cycle.”

Endometriotic lesions are made of tissue that resembles the lining of the uterus (the endometrial lining). These cells behave like the lining, so that once a month, during a woman’s cycle, the tissue swells, sheds and bleeds. However, since it has no pathway out of the body, it creates inflammation that can also lead to scarring.


Endometriosis can affect fertility in multiple ways.

  • Inflammation can create a toxic environment in the uterus, making it difficult for an embryo to attach to the lining.
  • Over time, inflammation from endometrial implants can lead to scarring. As a result, filmy adhesions may develop between organs within the pelvis, or may affect the fallopian tubes, making it difficult for sperm to reach an egg.
  • Endometriosis in the ovaries can cause endometriomas, cysts that affect ovarian function. It can also affect the quality of a woman’s eggs.

Endometriosis experts are better at identifying and removing all lesions, pelvic adhesions (or scars), endometriomas or treating affected fallopian tubes. In many cases, if fallopian tubes are too damaged or there is a high risk of an ectopic pregnancy, the tubes can be removed in advance of IVF treatments to ensure healthy implantation.


If endometriosis is identified and treated early there is a greater chance of reducing the overall damage to the pelvic cavity, and minimizing long-term damage.

Signs of endometriosis include:

  • Painful cramps or localized pain in the pelvis
  • Heavy bleeding
  • Difficulty going to the bathroom (pain with bowel movements, blood in urine or stools during menstrual cycle)
  • Low back pain
  • Pain during sex

“The extent of endometriotic implants is not correlated with the amount of pain a patient reports,” said Paul MacKoul, MD. “It is possible for a patient to have severe debilitating pain yet only very small implants.”

If surgery is necessary, laparoscopic endometriosis excision make it possible for many women to regain normalcy in their lives sooner than with open, more invasive procedures.

Endometriosis excision is the gold-standard procedure for treating the condition. Excision is a procedure that removes lesions from the pelvic cavity, or other areas of the body.

“When non-specialists resort to performing hysterectomies as an endometriosis treatment, they often ignore or are not aware of endometriosis lesions,” continued MacKoul. “If lesions or scar tissue is left behind during a surgical procedure, it can continue to cause intense pain or other symptoms, so it is essential to consult with a specialist who can remove the disease effectively.”

Endometriosis can also cause damage to the surrounding structures in the pelvis.

“When it comes to this complex gynecological condition, finding a GYN specialist who is an expert in localized endometriosis excision and who can perform necessary bowel, bladder and ureter repairs is essential,” said Rupen Baxi, MD. “These are delicate structures that can be damaged during excision, and must be repaired at the same time to avoid complications.”

“Endometriosis responds to estrogen,” said Danilyants. “In some cases, hysterectomy with removal of the ovaries is appropriate for women who do not desire fertility, or for women for whom excision alone has not managed to control the pain. However, each condition appears differently, and must be reviewed thoroughly by a specialist before surgery is recommended.”

The Center for Innovative GYN Care (CIGC) is dedicated to providing information and materials for women to help navigate the complicated healthcare system. The CIGC surgeons advocate on behalf of women suffering with endometriosis. Their minimally invasive surgical specialists have seen firsthand the pain and anxiety that women from around the world face before getting a proper diagnosis, evaluation and treatment. The CIGC practice believes that removing barriers to surgery includes making it accessible and affordable, including accepting most major insurance plans.

The CIGC specialists developed DualPortGYN for laparoscopic endometriosis excision. Two 5 mm incisions (one placed at the belly button and one is placed just above the pubic bone) make it possible for women to recover from surgery in a week or less.

CIGC founders Dr. Paul MacKoul, MD and Dr. Natalya E. Danilyants, MD are minimally invasive GYN surgical specialists who developed their advanced GYN surgical techniques using only two small incisions with patients’ well-being in mind. Dr. Rupen Baxi, MD is a CIGC-trained minimally invasive GYN specialist with extensive fellowship training and a respected speaker and researcher. Book a consultation at The Center for Innovative GYN Care

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