Killer Cramps: Everything You Need to Know about Endometriosis

From the Show: HER
Summary: Endometriosis is the leading cause of infertility and can cause a handful of unpleasant symptoms.
Air Date: 3/26/15
Duration: 10
Host: Michelle King Robson and Pamela Peeke, MD
Guest Bio: Tamer Seckin, MD
tamer seckinTamer Seckin, MD, is a Board Certified gynecologist and laparoscopic surgeon in private practice in New York City, practicing at North Shore LIJ/Lenox Hill Hospital. He specializes in treating women with endometriosis. He is an internationally known specialist in minimally invasive advanced (laparoscopic) surgery, and is among a very limited number of gynecologic surgeons in the United States who is exclusively committed to the Deep Laparoscopic Excision of endometriosis.
Killer Cramps: Everything You Need to Know about Endometriosis
Endometriosis is a very serious disease that causes abnormal cell growth outside of where its supposed to be: your uterus. The lining of your uterus normally builds up over the course of your menstruation to prepare for a fertilized egg. The egg would then attach to this lining and grow as a fetus.

However, when you're not pregnant, the lining of your uterus sheds, which results in your period. When you have endometriosis, the endometrium lining can attach to your uterus, ovaries and fallopian tubes, where it starts abnormally growing. The more it grows, the more severe the symptoms.

What are the symptoms of endometriosis?

Some women never experience symptoms of endometriosis, but other women experience pelvic and low back pain, painful intercourse, painful urination or bowel movements, and infertility.

What are the treatment options for endometriosis?

Endometriosis can be treated with pain medication, birth control pills, and surgery, if needed.

What else do you need to know about endometriosis?

Tamer Seckin, MD, discusses everything you need to know about endometriosis and when you should consider seeing your doctor.

RadioMD Presents:HER Radio | Original Air Date: March 26, 2015
Hosts: Michelle King Robson and Pam Peeke, MD

Dr. Pam Peeke, New York Times best-selling author and founder of the Peeke Performance Center, and Michelle King Robson, leading women's advocate, entrepreneur and founder of EmpowHER.com host the show everyone's talking about. It's time for HER Radio.

DR PAM: Hi, there. I'm Dr. Pam Peeke. Michelle's off today. We're talking about killer cramps. Now, when you get those killer cramps, don't just sit there and ignore them. They could be endometriosis and this is a serious condition, ladies. Listen up out there in HER Radioland. So, we have an expert--very special and unique physician who's going to help us understand all things A to Z and endometriosis and those killer cramps. Dr. Tamer Seckin.
Am I saying that right, Tamer?

DR SECKIN: That's good enough. That's fine.

DR PAM: That's close enough? I'm always these things...Okay, well, you say it. You say it right.

DR SECKIN: It's Tamer Seckin.

DR PAM: Seckin. Got you. So, Dr. Seckin is a board certified gynecologist and laparoscopic surgeon on private practice in New York City. He founded the Endometriosis Foundation of America, the first research and advocacy foundation of its kind. This is wonderful and we're so happy about your work here. Your website is DrSeckin.com. We want to get right to it right here.Endometriosis. Tell us what it is.

DR SECKIN: Endometriosis is a disease that affects women who have periods. It's associated with periods with significant pain during periods; that also, though, has some other symptoms from adjacent organs. So, that is painful periods, painful bowel movements, nausea, gastrointestinal systems, significant. So, endometriosis is when the period material leaks backwards and implants on other surfaces in the body and causes scar tissue—inflammation. So, it's a disease of inflammation, really. Not just pain, but a general feeling of inflammation that causes fatigue and discomfort. Not feeling well.
DR PAM: Dr. Seckin, tell us why you call it a silent epidemic.

DR SECKIN: Silent epidemic because it does involve 1 of 10 women, if not more, because there is also infertility that you really have no idea. They never know they have endometriosis. Many of the disease symptoms are not recognized well into the late 20's, early 30's and it is just considered to have painful periods, but when this normalness is injected into a kid's mind when it's just a painful period, they live with it. They say, "Well, this is normal. Mother had it," and stuff. But, it's silent because nobody knows about of it. Breast cancer is one 1 out 8. Endometriosis is almost there at 1 out of 10. Even more. So, everybody knows about breast cancer. The breast area okay, I guess, to talk about, but when it is a period, a little bit private and the private parts of the body. People don't talk about it. Even doctors.

DR PAM: I find that fascinating as a physician and also as a women, it's easier for me to have those conversations and you, an expert and gynecologist, of course. It's right up your alley. But, you know, you're absolutely right. I was thinking about it with the Angelina Jolie revelations about breast cancer and everybody's talking about "Race for the Cure" and they're wearing pink. Meanwhile, you know and I know, that so many women are suffering out there and don't even know it.

So, how do they get diagnosed? I come in to your office and I say, "You know, I'm having killer periods and pain and discomfort. Help me." So, what do they have to do to get diagnosed?"

DR SECKIN: Well, first you are diagnosed, 90% already. You are among those that are the intelligent women who came to the gynecologist saying, "Look, I have something wrong and I think I know what it is." So, absolute diagnosis is really confirmed by looking inside and seeing it. But an experienced doctor, in the office, many times, above 90% can say, "This is endometriosis." Then, when we look inside, we confirm. We recognize it, but it is finally confirmed under a microscope. It has to be looked inside and recognized as under the microscope with glans and stroma being there because every pathology needs a pathological diagnosis.

DR PAM: Well, when you say look inside, what do you mean by that? Tell the women out there in HER Radio. What is she going to have? Something per vagina? Are they going to have a scope there?

DR SECKIN: First of all, in the office they do endovaginal sonogram as part of the exam. We have an idea whether there is a cyst or tenderness there. If they are tender during the exam and the uterus is extremely tender when you move around, you have a clear understanding, there is some scarring inside. Then, looking inside really means looking through the belly button with a telescope, unfortunately. And, we see everything, then. Ovaries, tubes.

DR PAM: I see.

DR SECKIN: The bowels. The ligaments. There's nothing that is going to escape our view there. So, that is with a telescope, a very small 3-5 mm camera. We go in and we blow things up on our HD monitor. We see everything.
DR PAM: Okay. Now, I'm diagnosed now with endometriosis. I'm your patient. What's the treatment? How do you treat endometriosis?

DR SECKIN: Well, here is the tricky part. Endometriosis has to be treated when it is diagnosed because women cannot have many times looking inside. In other words, looking inside and seeing--that is not the treatment. So, the lesions have to be removed. The inflammation tissue, together with the visible...It looks like chocolate and raspberry, blueberry stuff looking like little pimples inside. So, every month, those areas become like little focuses. So, they need to be recognized and removed completely, not—this is another important thing. Not just burned with electrical surgery or lasers, they need to be removed. That's the treatment which we call "excision surgery".

DR PAM: Wow.

DR SECKIN: This is where the treatment of endometriosis lies because if people do not get excision surgery, their likelihood of coming back for another surgery is very, very high. It's like treating an iceberg. You don't want to treat the tip, you want to get the diseased portion out and many women do exceptionally well.

DR PAM: I have a question for you. So, if a woman has endometriosis that's untreated and she's been having the killer cramps and then she gets pregnant, does that affect the ultimate endometriosis experience?

DR SECKIN: Well, it is a very good question. So, pregnancy, basically, suppresses endometriosis symptoms, but it's not a treatment. After the baby is born, the symptoms immediately come back. It's important to know that and to make sure infertility is not cause directly by endometriosis, but endometriosis is associated with infertility because many patients who are having difficulty getting pregnant, many of them, more than 50%, have endometriosis. But, with today's technology or other ways, this can be bypassed. However, pregnancy does not treat endometriosis. Many endometriosis patients do not get many pregnancies. They get one, if they're lucky and maybe two. That's it. They don't get four pregnancies. So, it is one of the main reasons of infertility.

DR PAM: Okay. Now, a quick one. So, at what age, on average, does endometriosis actually start showing up in women? Is it the teen years? Is it the young adult years? When is it?

DR SECKIN: Seventy to eighty percent of the time, the symptoms of endometriosis starts during the first period years—that's menarche. Around 11 an 13.

DR PAM: I see. Okay.

DR SECKIN: If you asked four endometriosis patients, "When did your pain start?" It started from the "get go" they say, three out of four.

DR PAM: I see. I see. Oh, my gosh. This has been absolutely fabulous. So, now you understand A to Z about endometriosis. Don't be sitting there in pain with your killer cramps, for crying out loud. You've got to get in with your gynecologist. Have a conversation and a full diagnosis.

Dr. Seckin, thank you so much for being on HER Radio. I'm Dr. Pam Peeke with Michelle King Robson. Like us on Facebook. Follow us on Twitter. And, stay well.