Endometriosis: A Multi-Tiered Approach to Care

Women's health experts discuss endometriosis symptoms and patient-specific treatment options

It is estimated that endometriosis affects around 10% of women globally. It is extremely common for women to have years in between the onset of symptoms and the diagnosis of the disorder due to symptoms shared among other conditions.

David Soper, MD, Cristian Thomae, MD, and Tara Van Leuven, MD are three of MUSC Women's Health Experts who have special interest and focus in helping patients who have been diagnosed or think they may have endometriosis.

Endometriosis tends to affect women at two very different phases of life, either in adolescence or adulthood when many women may be hoping to achieve pregnancy.

Some of the most common symptoms of endometriosis include:

• Chronic pelvic pain
• Pain with menstrual periods
  • This is the most common symptom in adolescence. Parents and caregivers may want to take extra note of this when discussing period pain with teenagers.
• Pain with intercourse
• Difficulty trying to become pregnant

Additional symptoms to be aware of are:

• Painful bowel movements
• Painful urinations
• One-sided pain

Treatment options can vary based on each patient and her current healthcare and personal goals. MUSC Women's Health providers practice shared decision making which means providers and patients work together to make decisions and select tests, treatments and care plans based on clinical evidence that balances risks and expected outcomes with patient preferences and values.

The primary course of treatment will depend on if patients are trying to control symptoms or if they are trying to get pregnant since a usual first course of treatment will be approached with a hormonal suppression medication in the form of an oral contraceptive. This is usually approached in combination with a non-steroidal anti-inflammatory medication such as ibuprofen. When this works, patients tend to see their periods regulated, pain alleviated and discomfort decreased.

Another treatment option is surgery. Dr. Thomae is the director of minimally-invasive surgery for MUSC Women's Health and is comfortable discussing this option with patients if they have tried birth control or other treatment options without success. This is also a preferred treatment method for more complex cases of endometriosis.

Laparoscopic surgery tends to provide a firm diagnosis which prepares the patient to better approach her treatment. Surgical options also tend to be an ideal option for women who are trying to improve their fertility.

Oftentimes, following surgery, medications such as ORILISSA or ORIAHNN, which drop the estrogen levels in women and shrink the size of the endometriosis, will be prescribed as another component of treatment.

The great benefit to patients seeking care for endometriosis at MUSC Women's Health is the research conducted on campus and a team of experienced experts who see some of the most complex cases.

The team at MUSC Women’s Health wants to assure individuals that a diagnosis of endometriosis does not mean all is lost. While there is still a lot to learn about this disorder, there are a number of treatment options and experts to help patients develop a thorough care plan..

For more information, check out this video of Drs. Soper, Thomae and Van Leuven discussing endometriosis as part of an MUSC Women's Health Facebook Live event.

To learn more and find an MUSC Women's Health location or provider near you, please visit: muschealth.org/medical-services/womens/gynecology