Shining a light on endometriosis

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“My sister has endometriosis,” is overheard in the break room. “So does mine,” comes the response. If you’ve seen and heard more about this diagnosis in recent years, you’re not the only one. There seems to be a proliferation of articles in the media about endometriosis. So, what’s behind this trend?

“It is definitely patient driven as 1 in 10 women suffer from endometriosis,” Dr. Elizabeth Randle, IWK Gynecologist OBGYN, says. “I think as a society, we’re getting better at talking about women’s health issues in general.”

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While researchers haven’t figured out the exact science yet, they do know for sure that endometrial tissue (uterine lining) ends up in other places in the body, including ovary, pelvis, and sometimes even the brain.

Randle indicates that the symptoms of endometriosis can vary widely, but it often presents as painful periods, painful intercourse, infertility and chronic pelvic pain. Because the symptoms differ from woman to woman, there can often be a delay in diagnosis.

“And unfortunately, primary care providers may attribute these symptoms to ‘normal period pain’”, Randle says. “Thankfully, as women continue to discuss their symptoms with each other and learn more about endometriosis, they can advocate for their own health and ask for a referral to a gynecologist.”

Currently, gynecological exams and laparoscopic surgery are still widely considered the gold standard for diagnosis. Randle, states, however, that the gynecologic community is moving towards making a clinical diagnosis instead.

“It’s a very individual decision whether to have surgery or not and it has to be the right surgery for the right patient at the right time,” Randle says. “Ideally, it will be one surgery to confirm the diagnosis and simultaneously treat.”

It is an area of ongoing research, with more medical advances, including newer medications being developed. Randle’s personal research, in conjunction with the department of anesthesia, has been awarded a Translating Research Into Care (TRIC) funding grant Level 1 to explore the feasibility of a multi-disciplinary clinic to manage endometriosis and chronic pelvic pain.

Randle, originally from Toronto, completed her residency in Ob/Gyn through Dalhousie University at the IWK. She then completed a fellowship in Minimally Invasive Gynecologic Surgery through the University of Saskatchewan. She returned to Halifax and the IWK in 2017.

Advice for patients:

“Be your own advocate – you know your body best. Bring a symptom calendar to your family doctor, bring a partner or a friend – women tend to downplay their own symptoms. Ask your family doctor for a referral to a gynecologist if you feel your symptoms are not being managed adequately.