Endometriosis Mythbusters: Separating Fact from Fiction Part 2
Thank you to CIGC Director of Education and Community Outreach Nilofar Kazi, CIGC co-founder and surgeon Dr. Natalya Danilyants, and to all those who participated in this discussion about endometriosis myths and misconceptions.
We look forward to seeing you all next year when we resume our Facebook Live events!
Watch the recording here
Our Facebook Live event on myths and misconceptions surrounding endometriosis was so popular during our first event that we decided to debunk even more myths in a second event. CIGC Director of Education and Community Outreach Nilofar Kazi once again joined CIGC co-founder and GYN surgical specialist Dr. Natalya Danilyants to discuss endometriosis treatment and surgery myths.
Myth: Pregnancy is the ultimate cure for endometriosis.
Not only does pregnancy not cure endometriosis, it can actually be very difficult to become pregnant when you have the condition. Depending on the severity, the effect of endometriosis can range from increased levels of inflammation in the body to a serious distortion of the pelvic anatomy. These effects can lead to problems with conceiving and carrying a baby.
“A lot of patients — even with mild endometriosis — can have trouble getting pregnant,” Dr. Danilyants said. “It also may take them a much longer time to get pregnant compared to someone their same age who doesn’t have endometriosis.”
When someone with endometriosis does manage to become pregnant, their symptoms may temporarily subside due to altered hormone levels during pregnancy. Once those hormones return to their baseline levels after pregnancy, symptoms like pelvic pain and heavy bleeding are likely to come back.
Myth: People with endometriosis have to undergo multiple surgeries for the rest of their lives.
Many people express fear at the prospect of having just one surgery, let alone the idea of multiple surgeries. When treating endometriosis, the efficacy of the initial surgery can impact the rate of recurrence.
While the likelihood of recurrence depends on multiple factors, one of the most important factors is how thorough the removal of endometriosis was during the first surgery. Incomplete removal, which is common when undergoing ablation or cauterization (otherwise known as burning), leads to a much higher chance of recurrence and, in many cases, subsequent surgeries. Excision surgery — cutting out endometriosis laparoscopically through small incisions — is the best treatment for endometriosis at all stages. Excision surgeons cut out endometriosis lesions along with their roots, resulting in a much lower likelihood of recurrence. Ablation only burns visible endometriosis, leaving any roots behind.
“The research shows that recurrence rates after ablation can be as high as 60% within the first two years after the initial surgery,” Kazi said.
The other important factor for success of endometriosis surgery is your surgeon’s level of skill. For the best chance of a successful endometriosis excision surgery, your surgeon needs to be an expert in complete laparoscopic endometriosis removal.
“If you don’t want to have multiple surgeries, you really have to focus on who you’re reaching out to for that initial surgery,” Kazi said. “Surgeries that aren’t performed thoroughly the first time often create scar tissue and other adhesions that are then left behind, which in turn can cause pain and problems with fertility.”
You deserve an endometriosis excision expert. Our patient advocacy team can connect you with a specialist today.
Myth: A hysterectomy is the only way to relieve yourself of endo pain.
Endometriosis is the growth of uterine tissue outside of the uterus, so removing the uterus in a hysterectomy surgery does not prevent endometriosis lesions from continuing to grow and spread. The condition is estrogen-dependent and is controlled by the ovaries. But removing the ovaries may not be the best option for women who want to maintain their fertility or for women who are young and not ready to enter menopause. In those cases, endometriosis excision is the best treatment option.
Some women have uterine tissue that grows into the uterine muscle, a condition called adenomyosis. For those women, removing the uterus may be the best option to relieve pain.
“Although a hysterectomy has a negative connotation, it helps a lot of women,” Dr. Danilyants said. “It helps with abnormal bleeding, it helps with adenomyosis and it can be done minimally invasively. Hysterectomy does not mean open surgery, it does not mean hospital stay and it can be done with very small incisions.”
Myth: Endometriosis and adenomyosis are the same.
Sometimes endometriosis lesions are not the only problem that’s causing pain. Adenomyosis — characterized by uterine tissue growing into the muscle of the uterus and thickening the walls of the uterus — is another common condition that can lead to symptoms that are very similar to the heavy bleeding and pain of endometriosis. But endometriosis and adenomyosis are not the same.
Unlike endometriosis, evidence of adenomyosis can show up on an MRI. It’s not possible to remove adenomyosis from the uterine muscle without damaging the uterus, so the only treatment for the condition is a hysterectomy.
“[For an adenomyosis diagnosis,] I would say first start with an ultrasound,” Dr. Danilyants said. “And if the ultrasound looks ‘normal’ and you’re suspecting adenomyosis, you can do an MRI.”
Myth: Insurance doesn’t cover endometriosis treatment and patients need to pay out of pocket.
Health insurance companies can be difficult to work with on coverage for endometriosis, so some providers opt to remain out of network with major companies. This allows those providers to set their own prices, require large up-front payments and tell patients they can be reimbursed for endometriosis treatment through their insurance company directly. But that reimbursement may never materialize.
“Some surgeons decide they do not want to work with insurance, so they come up with their own price for surgery,” Dr. Danilyants said. “But the issue with that is it’s just what that doctor decides. If that doctor decides they’re going to charge $20,000 for their surgery, then that’s what they’re going to charge. In my experience, a majority of the cash-only doctors do go to the extreme in terms of what they’re going to charge.”
High up-front expenses for endometriosis surgery can lead to a lot of patients being denied care because they can’t afford to pay out of pocket. At CIGC, we believe finances should never stand in the way of the endometriosis treatment you need, so we are in network with most major insurance companies. Our patient advocacy team will work with you to maximize your insurance benefits so you can get the care you need without breaking the bank.
Are you ready to move forward with endometriosis treatment? Talk to our patient care team about your options today.
CIGC Wellness Center
We are pleased to announce the recent opening of The CIGC Wellness Center at our Rockville, Maryland location. CIGC Wellness Center offers an integrative approach to treating complex GYN conditions through holistic therapies such as acupuncture, physical therapy and nutritional counseling.
Each patient’s Wellness Center experience will begin with an evaluation with one of our GYN specialists, who will then recommend a treatment plan based on each patient’s individual needs and interests.
Our initial slate of therapies includes accupuncture, nutritional counseling, pain management, pelvic floor physical therapy, physical training and psychotherapy.
Endometriosis Mythbusters: Separating Fact from Fiction Part 1
Despite affecting at least 11% of women in the U.S., endometriosis continues to be a largely misunderstood GYN condition. From potential causes of endometriosis to wide-ranging characteristics of the disease, there’s a lot of misinformation out there. CIGC Director of Education and Community Outreach Nilofar Kazi joined CIGC co-founder and GYN surgical specialist Dr. Natalya Danilyants for part 1 of debunking the many falsehoods surrounding endometriosis. Watch the recording or read the recap on our website.