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The frequent dismissal of this chronic condition remains a significant challenge for the nearly 10% of women who experience it.
In a culture that often trivializes women’s pain, many doctors have been known to underestimate the severity of endometriosis complications. This tendency has led to the disorder being widely underreported, with experts noting that it can take a decade or more for a proper diagnosis to be made.
Dr. Sheeva Talebian, a board-certified reproductive endocrinologist and the director of third-party reproduction at CCRM New York, finds this trend deeply troubling.
“Enduring pain shouldn’t be considered part of being a woman,” she told The Post. “We need to eliminate the ‘grin and bear it’ mentality where women are expected to endure severe pain without complaint.”
Endometriosis is a chronic inflammatory condition affecting menstruating women, characterized by the growth of uterine-lining tissue outside the uterus. This tissue typically appears on other reproductive organs but can also be found on the bowels or bladder, and in very rare cases, on distant areas like the lungs.
Because it can be so excruciating, endometriosis-related pelvic pain is often the first symptom associated with the disorder. Not all endometriosis patients experience pelvic pain, which only makes it harder to diagnose. (Current diagnostic tools include uterine biopsies or MRIs that look for inflammatory markers.)
Other symptoms include fatigue, joint pain, shortness of breath, painful sex, irritable bowels, urinary frequency and infertility, among other things.
For the 30% of couples who experience unexplained infertility — or those whose fertility tests come back normal but who are having trouble conceiving — Talebian recommends asking a doctor if endometriosis may be at play, even if other classic symptoms like pelvic pain aren’t a factor.
Across the board, endometriosis patients frequently talk about how important it’s been for them to be their own loudest advocates in a doctor’s office. Talebian agrees.
“If a provider dismisses your pain as ‘normal,’ let that be your signal to find a new member for your care team,” she said. “You deserve a clinician who looks at the data, validates your experience and uses the tools we have to help you thrive.”
Even though there is no known cure for endometriosis — heck, there isn’t even a single “gold standard” diagnostic tool — Talebian insists there are some “science-backed” lifestyle changes that patients can make to manage the disorder, “whether your goal is to preserve your fertility for the future or simply to live a day without being sidelined by your symptoms.”
Outside of surgery to remove the uterus, there are some medical interventions — like a steady dose of estrogen and progestin hormones — to suppress ovulation, which leads to spikes in estrogen. Those spikes may worsen symptoms and disease, Talebian explained.
But a lot of endometriosis management comes down to lifestyle. Building a routine with as many anti-inflammatory elements as possible can go a long way in keeping the most disruptive symptoms at bay.
Talebian suggests regular exercise, acupuncture and potentially adding some inflammation-lowering supplements to your rotation, like coenzyme Q10 or turmeric.
Diet is another key lever. The Endometriosis Foundation recommends reducing consumption of processed foods, red meat and alcohol and replacing them with a Mediterranean diet rich in fruits, vegetables, oily fish, olive oil and nuts, which can help reduce inflammation in the body.
A 2022 scientific literature review echoed the call for omega-3-rich fish oil, plus getting enough C, D and E vitamins.
The study emphasized that “the management of endometriosis requires a holistic approach” and that dietitians can help with symptom management, especially in younger or early-stage patients.
“These lifestyle modifications, unfortunately, will not ‘cure’ the disease,” Talebian said, “but may help ease some symptoms and potentially slow progression.”