Endometriosis: So much more than period pain

This content is sponsored by The Center for Innovative GYN Care

Imagine living with debilitating and disruptive pain for up to 10 years, before a doctor accurately diagnoses what is happening to you. For the nearly 300 million women worldwide, this is what it’s like living with endometriosis.

March is Endometriosis Awareness Month. In March, yellow ribbons signify the call to action to advocate for more research, better treatments, and education about how the disease impacts women’s lives. Knowing the signs of endometriosis, how to get a proper diagnosis, and understanding the best treatment options can empower women to take back their lives.


Endometriosis is a painful chronic condition that occurs when cells, similar to those in the lining of the uterus, are discovered in the pelvic cavity—or, in rare cases, it can be found in other areas of the body, including the lungs and in the brain. These cells behave like the endometrial 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. If ignored, the pain can become constant.

The American Society for Reproductive Medicine estimates that up to 50% of women with endometriosis will suffer from infertility. This occurs because the disease can cause severe inflammation in the pelvis. This inflammation can cause scar tissue to form in and around the tubes which prevents the transport of an egg into the uterus during ovulation.

“Many suffer in silence for years before bringing their symptoms to the attention of a healthcare provider. Misdiagnosis often occurs. It is estimated that 3-11 years elapse from the onset of pain to final diagnosis. The frustration, expense, time, and mental exhaustion that women and families experience is undeniable.“ said Dr. Vanessa Sarfoh, CIGC physician.

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

Despite a history of endometriosis in her family (her mother had it on her liver), Lauren’s  doctors dismissed her symptoms: “I asked if my endometriosis could be attaching to other areas, but all of my doctors whether GP, OBGYN or the ER doctors said no, that it would only attach to the woman parts.”


Women often experience difficult menstrual cycles starting in their teens. 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.

Early diagnosis is critical, and the only way to formally diagnose endometriosis is with a tissue biopsy. The surgeons at CIGC use small incisions to perform laparoscopy (using a long thin camera and long thin instruments) to examine the pelvis and remove and/or burn all visible lesions. This alone often significantly improves pain symptoms. In addition, it gives women an answer and a starting point to discuss treatment options. In Lauren’s case, Dr. Natalya Danilyants found a quarter-sized piece, which was sent to the lab and confirmed for endometriosis.

These diagnostic surgeries should be performed by a well-trained minimally invasive gynecologic surgeon who is very familiar with the condition and the varying appearances of endometriosis implants.


While there is no cure for endometriosis, women have multiple treatment options depending upon their desire to preserve fertility or not. In some cases, doctors will recommend a hysterectomy, but since endometriosis can present outside of the uterus, this does not always result in relief.

When it comes to treating endometriosis, excision is the gold-standard procedure. Excision is a procedure that removes lesions from the pelvic cavity, or other areas of the body. According to Dr. Paul MacKoul, “Minimally invasive endometriosis excision is a specialty procedure that requires expert surgical precision as well as knowledge of techniques to prevent future scarring. It also requires an understanding of the patient’s long-term plans for fertility. Radical stripping of endometriosis can damage the delicate reproductive organs, which can be avoided with advanced laparoscopic surgical techniques.”

Lauren knows firsthand how life-changing the procedure can be.

“I only go to her [Dr. Danilyants] now. I got rid of all of my other doctors. About every two years, I need to go in for a tune-up, but it’s part of managing the disease. This is part of my treatment plan. I don’t feel the incisions, I don’t feel on the inside where she has removed the endometriosis…”

For some advanced stages of endometriosis, in addition to excision, a hysterectomy that removes the ovaries may be necessary as estrogen is linked to the proliferation of endometriosis. Although a hysterectomy does not cure endometriosis, removing organs that have been damaged due to pelvic adhesions and inflammation can alleviate pain.

Like Lauren, Michelle had a family history of endometriosis. In Michelle’s case, the endometrial implant was large and had fused the uterus to the bowel, causing rectal bleeding with each monthly cycle. In addition to performing a minimally invasive hysterectomy and endometriosis excision, Michelle’s bowel needed to be repaired with an enterolysis procedure. Using DualPortGYN, a technique developed by the minimally invasive surgeons at CIGC, Dr. MacKoul was able to do these very complex procedures with two tiny incisions.


While endometriosis cannot fully be cured, choosing a GYN specialist for removal is an essential part of managing the condition. If removed incorrectly, endometrial implants can continue to cause pain and affect fertility.

CIGC advanced surgical specialists developed the DualPortGYN technique used for minimally invasive endometriosis excision. This procedure uses two 5mm incisions, one at the belly button and another at the bikini line, so patients have a better overall recovery and return home the same day. All procedures are performed in an outpatient setting. The DualPortGYN technique uses an advanced procedure that maps the pelvis, allowing for complete identification of all the structures of the pelvis — such as the bowel, bladder, ureters, and large vessels — allowing for safe, fertility-friendly, and effective results with the best recovery possible.

The Center for Innovative GYN Care is dedicated to helping women through this difficult condition. If you or someone close to you is suffering from pelvic pain, endometriosis symptoms, or are having trouble with fertility treatments, it is important to seek a minimally invasive GYN specialist for an evaluation. CIGC minimally invasive GYN surgical specialists Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD developed their advanced GYN surgical techniques using only two small incisions with patients’ well-being in mind. Book a consultation at The Center for Innovative GYN Care or call 888-SURGERY.

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