Recognizing the systemic effects of endometriosis may help doctors better understand the experiences of patients with the disease and guide the approach to diagnosis and treatment, according to the president of the American Society for Reproductive Medicine (ASRM).
Beyond lesions in the pelvis, endometriosis may underlie a range of co-occurring conditions, such as generalized inflammation, fatigue, bowel or bladder dysfunction, depression, and anxiety, Hugh S. Taylor, MD, said at the 2021 virtual meeting of the American College of Obstetricians and Gynecologists.
Its systemic manifestations may explain why women with endometriosis tend to have a lower body mass index, compared with women without the disease, Taylor said.
"Stem cells, microRNAs, and generalized inflammation are some of the mechanisms that mediate these long-range effects on distant organ systems," he said.
Studies have indicated that lesions in the pelvis do not fully explain the disease, and investigators continue to elucidate how "endometriosis that we see in the pelvis is really just the tip of the iceberg," said Taylor, chair of obstetrics, gynecology, and reproductive sciences at Yale University, New Haven, Conn.
Pain, including dysmenorrhea, pelvic pain, and dyspareunia, "can be just as bad with stage 1 disease as it can be with stage 4 disease," he said.
