Debunking Endometriosis Myths: A Talk by Dr. Chu

Despite its high prevalence, endometriosis continues to be a mysterious disease. Numerous factors contribute to this including social and medical stigmas and lack of adequate awareness among patients and healthcare providers. This leads to many endometriosis myths.

During the annual Patient Day 2024, Dr. Amanda Chu from the Seckin Endometriosis Center delivered a riveting talk that addressed some of the commonly prevailing notions about the disease.

Myth: I don’t have endometriosis as my periods don’t hurt

Although endometriosis causes symptoms such as period pain, it alone is not an indicator of the presence or absence of the disease, according to Dr. Chu.

She said 20-30% of endometriosis is silent endometriosis and symptoms may develop in the future. She also reaffirmed that the degree of pain and endometriosis staging do not correlate. 

“Up to 45% of unexplained infertility may be due to silent endometriosis,” she said.

Myth: You’re 17. You are too young to have endometriosis

Research has shown that adolescent endometriosis is a reality, Dr. Chu said during her talk.

There is a prevalence of 47% among adolescents, ages 10 to 19 years and this increases to nearly 70% for those under age 22 who do not respond to traditional birth control measures.

Adolescent endometriosis is complex; patients tend to experience acyclic pain and many experience moderate to severe endometriosis.

Fact: Endometriosis increases your risk of having cancer

Although endometriosis itself does not cause cancer, endometriosis lesions do show oncogenic features such as angiogenesis or the formation of new blood vessels, organ invasion, resistance to programmed cell death, and development of lesions.

In particular, there is an increased risk of ovarian cancer along with the probable risk of breast and thyroid cancers.

Create an individualized plan with your endometriosis provider to talk about your own reproductive goals, your personal risk factors, and your family history, Dr. Chu said.

Myth: A hysterectomy will lead to immediate menopause

Hysterectomy refers to the partial or complete removal of the uterus. A complete hysterectomy that includes removal of the uterus, cervix, and bilateral ovaries results in menopause. In all kinds of hysterectomies, the fallopian tubes are removed. Complete removal of the fallopian tubes reduces the chances of ovarian cancer by 64%.

However, menopause occurs 1 to 2 years earlier if only one ovary is removed during hysterectomy, Dr. Chu explained.

Fact: There is no way to diagnose endometriosis without surgery

Although several non-invasive diagnostic techniques such as imaging and the BCL-6 test are becoming common, the gold standard for endometriosis diagnosis remains laparoscopic deep excision surgery followed by a histological examination. Researchers are also looking at salivary signatures and menstrual effluents as possible biomarkers.

Myth: Antibiotics can treat endometriosis

Endometriosis is not an infectious disease, and no antibiotics can cure it, Dr. Chu stressed.

However, certain infections such as pelvic inflammatory disease and Fusobacterium infection can promote endometriosis. So, treating them with antibiotics can improve endometriosis progression although direct evidence is lacking, she explained.

Myth: Pregnancy cures endometriosis

Pregnancy is not a cure for endometriosis. In fact, endometriosis has no known cure.

However, pregnancy being a high-progesterone and amenorrheic state can cause a reduction in symptom severity that can continue during breastfeeding.

Those with laparoscopically proven endometriosis are at an increased risk of adverse pregnancy outcomes. There are no standardized guidelines for pregnant women with endometriosis.

“Pregnancy should not be suggested against patient preference,” Dr. Chu stressed.