Endometriosis: Let’s talk about it (and get clear)

For today’s post, we interviewed Dr. Shyama Mathews, one of the two practicing gynecologists at WHP. At the practice, where she has worked since 2016, Dr. Mathews provides annual exams, preventive care, disease screening and treatment, family planning, and preconception counseling. Her focus is medical and surgical management of gynecological conditions and disorders, including abnormal uterine bleeding, large uterine fibroids, endometriosis, and chronic pelvic pain. She is passionate about endometriosis--she knows it is a commonly misunderstood condition among women and wants women to be informed.

Quick fact: “Endometriosis is a disease of menstruation. It occurs when tissue similar to the lining of the uterus, or endometrium, migrates outside of the womb, where the tissue should not be. The result is inflammation, as the tissue responds to the monthly fluctuations of a woman's menstrual cycle.” Find this, and more, at Endometriosis Foundation of America.

WHP: Can you break down endometriosis for us? What do we need to understand?

SM: Endometriosis is a condition affecting up to 10% of reproductive age women, but it often takes years (up to eight years!) to diagnose. It can only be definitively diagnosed through surgery, but one can have a strong clinical suspicion based on signs and symptoms. Once we diagnose these signs and symptoms in a patient, we can get medical treatment for that patient started right away.

WHP: What are the typical symptoms of the condition?

SM: Typical symptoms include extremely painful periods associated with nausea and vomiting, pain with bowel movements or urination, and pain with sex. The pain starts with periods but can progressively present for longer periods of time, starting before periods begin by two weeks (ovulation) and even extending past periods by a few days. Patients have told us they only have one painfree week out of the entire month!

WHP: What makes this disease so challenging to live through and manage for women?

SM: Endometriosis is a particularly complicated disease because the severity of the symptoms do not necessarily correlate with the extent of the actual disease. These implants of endometriosis can be everywhere within the pelvis. When there is extensive disease, careful dissection must be performed to excise (to cut out) the disease, without harming surrounding structures.

WHP: Why are you passionate about talking about and informing women about endometriosis? In other words: why is it critical this condition be more widely understand in women’s health?

SM: I am passionate about this because so many girls and women are suffering in silence. And, endometriosis affects so many women! Many girls and women do not realize their level of pain is abnormal. Others have been told by prior doctors it IS normal, it will get better over time, they will grow out of it, or, worst of all--the pain in their head!

Instead, they should have been told, “Hey, there is a good chance you have endometriosis and we should be proactive about treating it, so it does not get worse.”

Women need to be educated about this disease and how it can progress over time, so they can be advocates for their own health. It is a conversation that takes time--treatments may involve multiple layers of medication, surgery, and therapy, and endometriosis is a chronic disease that may never be cured. But, knowing about it, learning how to best manage it, how to live with it, and how to plan for it--this all leads to better overall function and quality of life for women.

For more information, also check out endowhat?.

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