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15-45 million may have endometriosis!

May 7, 2015

Dr. Fox responds to the following articled.
Yet another relatively inaccurate article about endometriosis.  The article suggests the following
1.  5 million with endometriosis:
    Text book is 8-10% and we would argue 20-30% of reproductive age women have endo
    In the US there are approx 150Million reproductive age women so 15 to 45 million would be a better estimate
2.  There is no cure:  (later they mention “recurrence”)
    Yes there is:  Surgical excision.  The problem is there are no studies to prove this concept and it is now buried in the history books from the 1900 -1970 timeframe.  We have a study presented at ASRM that clearly outlines this procedure is curative for endometriosis.  Only a handful practices in the US offer complete excision for endometriosis and we are so busy taking care of patients that it is hard to have time to do research and surgical research is hard and takes years to accomplish.  Later in the article they allude to cure with, “only by taking out the disease tissue can we be sure we’ve  stopped this disorder?  So which is it? Cure or recurrence.  Far too much confusion in the issue.  They admit that no medicine cures the disease which we definitely agree with.  Medicines that suppress pain create a false sense of security because the disease continues to progress, just with less pain.
3.  Endometriosis causes nausea:
    While it is possible, this article gives the impression that this is a major symptom in patients.  We see this as a relatively uncommon component of the pain syndrome.  We have had a few patients with improvements in nausea after curative treatment but this is not common.  This patient had bariatric surgery that results in a great deal of nausea, diarrhea, and other bowel issues.  As always hormones and the menstrual cycle play a big role in bowel motility and complaints.  A large uterus filled with endometriosis in the muscle (adenomyosis) will release more prostaglandins than normal that will dramatically effect bowel function.  In this case, removal of a sick uterus and control of hormones is likely the reason for improved nausea.
The title of the article, “For women with endometriosis, answers are few” is realistic in that for the majority of gynecology there are few answers and the disease remains an enigma.  For many years, we have learned about endometriosis and tailored treatments to the underlying issues with great success.  There are few of our patients that don’t get significant relief.  For further questions call us at 904 493 2229.
Michael D. Fox, MD
Jacksonville Center
Reproductive Medicine 

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