Leaders in reproductive medicine from more than 100 countries were today urged to help prevent women suffering from the debilitating effects of endometriosis from embarking on “diagnostic misadventures.”
Speaking at the 2022 Congress of the Asia Pacific Initiative on Reproduction (ASPIRE), Professor Hugh Taylor, an eminent American specialist in reproductive endocrinology, said endometriosis was now recognized as a systemic disease.
He said the complex systemic nature of endometriosis meant the traditional diagnosis of pelvic pain was “just the tip of the iceberg” in the often profound impacts of the disease that affects up to 10 per cent of women of reproductive age around the world.
Despite its prevalence, Professor Taylor said in many cases it took years from the onset of symptoms involving multiple physicians to conclusive diagnosis of endometriosis.
“Misdiagnosis is common and delivery of effective therapy is prolonged,” he explained.
“Endometriosis is classically defined as an chronic gynaecological disease characterised by endometrial-like tissue present outside the uterus, and is thought to arise from retrograde menstruation.
“However, this description is outdated and no longer reflects the true scope and manifestations of the disease. Endometriosis is a systemic disease rather than one predominantly affecting the pelvis.”
Professor Taylor, former President of the American Society for Reproductive Medicine and Chief of Obstetrics and Gynaecology at Yale University, said other symptoms of endometriosis could include anxiety and depression, fatigue, inflammation, low body mass index (BMI), bowel or bladder dysfunction or onset of cardiovascular disease.
“Diagnosis and treatment is very challenging because symptoms are not specific,” he told the ASPIRE Congress, which is addressing the physical and psychological obstacles facing couples striving for parenthood and latest global advances in infertility treatment.
“Endometriosis is a disease of cell traffic that can spread throughout the body having adverse effects of distant organs, including an alteration to gene expression in the brain that can cause pain sensitisation and mood disorders.”
“Recognition of the full scope of the disease will facilitate improved clinical diagnosis and allow for more comprehensive treatment than currently available.”
Professor Taylor said surgical treatment could remove visible lesions without reversing all the remote effects of endometriosis on other organs, and that a better understanding of the disease could lead to the development of more effective tests and personalised treatments.
“But we are still in the discovery phase as the full effects of endometriosis, outside the parameters of a classic gynaecological disease, are not fully recognised,” he explained.
“We need physicians and patients to work together to help recognise the wider symptoms and avoid diagnostic misadventures so that comprehensive care and full treatment of women with endometriosis can be achieved.”