Strange Migrations and Killer Cramps
– Understanding Endometriosis
According to the National Institute of Health, endometriosis is linked to pain and infertility for 
many women. It occurs when cells like those which line the uterus (the endometrium) attach to other tissues and grow inside the lower belly. These out-of-place cells can be the start of a problem that can last a lifetime.
Endometriosis affects up to 1 in 10 women of childbearing age. Pain from endometriosis can range from extreme to barely noticeable. A woman may not know she has the disease until she has trouble getting pregnant and her doctor makes the diagnosis. About 40% of women with infertility turn out to have endometriosis.
“Endometriosis is an incredibly complex disease. Its causes have been somewhat of a mystery, and we aren’t sure how to prevent it,” says local urogynecologist and reproductive specialist, Dr. Armen Kirakosyan. However, researchers are currently working to find better ways to diagnose, treat, and perhaps even prevent endometriosis.
Many scientists think endometriosis occurs when some of the endometrial tissue sheds during menstruation flows backward into the pelvis. This strange migration known as retrograde menstrual flow, which happens to most women, doesn’t always lead to endometriosis,” says Dr. Kirakosyan.
Now researchers are hoping to determine why some women have endometrial cells that stick and grow where they don’t belong, and why others don’t. These misplaced cells, sometimes called lesions or implants, can also form scars between tissues and organs like the bladder, intestine or ovaries. However, the number and size of lesions aren’t related to the severity of symptoms.
Dr. Kirakosyan says, “Most often, endometriosis is treated with birth control pills to suppress the body’s natural production of reproductive hormones and also lighten the menstrual flow. However, the most advanced and effective treatment for endometriosis is surgical removal of the endometriotic lesions using minimally invasive laparoscopic robotic surgery. The procedure involves making a small cut in the abdomen and inserting a tiny light at the end of a tube, or laparoscope. This allows us to view patches of endometriosis inside the pelvic area and remove them completely.”
There is a lot of active research into the basic biological mechanisms of endometriosis, but there is a lot that doctors and scientists don’t yet know. “Once we understand the mechanisms, we’ll have better tools to help women deal with this serious problem,” says Dr. Kirakosyan. Since endometriosis tends to run in families, researchers have been looking for culprit genes. They are also looking for molecules in the blood that might help detect endometriosis without the need for laparoscopy. “Fortunately,” says Dr. Kirakosyan, “we have ways to minimize its symptoms.”
WNY Resource:
Armen Kirakosyan, MD FACOG, FPMRS is Medical Director of Minimally Invasive Gynecologic Surgery at Kaleida Health, a clinical assistant professor at University at Buffalo, and an OB/GYN at General Physician, PC. To make an appointment with Dr. Kirakosyan, call 716-656-4077.
