Endometriosis
What Is Endometriosis?
Endometriosis is a chronic, estrogen-dependent inflammatory disease where tissue similar to the lining of the uterus (the endometrium) grows outside of the uterus. You may also hear it called: “Endo”
It’s a common yet widely misunderstood disease, affecting up to 10% of women of reproductive age. While some women may have no symptoms, for many, it causes debilitating pain that can seriously impact daily life. Genetics also play a role; your risk is higher if a close relative like your mother or sister has the condition.
Where Does Endometriosis Grow?
Unlike fibroids which grow in the uterus, endometriosis implants can grow on many different pelvic organs:
- On the ovaries or fallopian tubes
- On the outer surface of the uterus
- On the tissues lining the pelvis
- On the bowel, bladder, or rectum
These implants respond to hormonal cycles, causing inflammation, internal bleeding, and scarring that can bind organs together.
Types of Endometriosis
The disease is classified by where and how deeply it grows:
- Superficial peritoneal endometriosis: The most common form, where small, flat lesions appear on the surface of the pelvic lining.
- Ovarian endometriomas: Also known as “chocolate cysts,” these are cysts filled with old blood that form inside the ovaries.
- Deep Infiltrating Endometriosis: The most severe form, where the disease grows deep into the tissues of organs like the bladder, bowel, and ligaments behind the uterus.
Common Symptoms
- Extremely painful periods
- Chronic pelvic pain outside of your period
- Pain during or after sex
- Painful bowel movements or urination, especially during your period
- Infertility or trouble getting pregnant
- Debilitating fatigue, often called “endo fatigue”
The pain from endometriosis is not the same as normal menstrual cramps. It’s important to know that the severity of your pain does not always match the amount of endometriosis found during surgery even a few small implants can cause significant symptoms.
If you’re feeling these symptoms, your pain is real and you deserve a specialist who understands.
How Endometriosis Affects Daily Life
Endometriosis is a whole-body disease that can affect every aspect of your life:
- Mental Health: Chronic pain is strongly linked to anxiety and depression.
- Social Life: Canceling plans, avoiding activities, and feeling isolated due to unpredictable pain flare-ups.
- Work & School: Missed days and reduced productivity are extremely common.
- Intimacy & Relationships: Pain with sex can strain relationships with partners.
- Body Image: Severe bloating and the physical toll of chronic pain.
Delaying Care Is Common But Can Be Costly
Even though endometriosis is disruptive, there is a significant delay in diagnosis. Major medical reviews confirm that, on average, women wait 7 to 10 years from the onset of symptoms to get an accurate diagnosis.
This dangerous delay is often because symptoms are dismissed as a “normal” part of menstruation by patients, families, and sometimes even by doctors. This allows the inflammatory disease to progress, potentially causing more damage and making treatment more complex.
What Are My Treatment Options?
Non-Surgical Options
- Pain Medication: Over-the-counter NSAIDs for mild pain.
- Hormonal Suppression: Birth control pills, progesterone IUDs, or GnRH modulators (like Myfembree or Orlissa) are used to suppress the menstrual cycle. These medications work by lowering estrogen levels and preventing ovulation, which can slow the growth of endometriosis lesions and reduce inflammation. However, they do not remove the disease itself and symptoms often return after stopping the medication.
At our practice, we prioritize laparoscopic excision surgery, which is considered the gold standard for treating endometriosis. The goal of this surgery is the complete removal of all visible endometriosis implants and scar tissue to provide the most effective and lasting pain relief. This is different from "ablation," which only burns the surface of the lesions.
- Laparoscopic Excision of Endometriosis: The standard minimally invasive approach to carefully cut out endometriosis implants while preserving healthy organs. A definitive diagnosis is confirmed by sending a biopsy for analysis.
- Robotic-Assisted Excision with the da Vinci System: Provides enhanced vision and precision, which is especially valuable for complex cases of Deep Infiltrating Endometriosis near delicate structures like the bowel, bladder, or ureters.
- Hysterectomy: This may be an appropriate option for patients who also have uterine-source pain and have completed childbearing. However, hysterectomy is not a cure for endometriosis, as the disease exists outside the uterus. Excision of all endometriosis lesions must still be performed at the same time.
Questions to Ask Dr. Kim During Your Visit
- Based on my symptoms, do you suspect I have endometriosis?
- What is the difference between excision and ablation surgery?
- How could endometriosis be affecting my fertility?
- What are my treatment options beyond birth control pills?
- If I need surgery, what is your approach?
Why Choose Us?
We provide expert care for fibroids with a focus on:
- Uterus-sparing treatments
- You’ll work exclusively with Dr. Kim throughout your journey
- Direct call/text access to Dr. Kim
- Advanced technologies when needed (da Vinci, Acessa)
- Fast recovery, less pain, quicker return to your best life
You do not have to "just live with" debilitating pelvic pain. It is not normal, and it is not something to ignore. Endometriosis is a complex disease that requires a specialist with deep expertise.
Whether you want relief from symptoms, want to preserve or improve your fertility, or have tried other treatments without success, know that there are advanced options available. Contact us today to learn more about endometriosis care and arrange a visit to our Park Ave office based in the Upper East Side, New York City.
