March Is Endometriosis Awareness Month: How Much Do You Know?


Endometriosis is a disease in which uterine-like tissues grow out of place and become inflamed during a woman’s menstrual cycle even though the tissues are outside the uterus. The condition can be difficult to diagnose because of its “vague” symptoms, which include lower abdominal pain, abnormal periods and fatigue. In fact, surgery is necessary for a definitive diagnosis. As a result, many women see multiple specialists before finding relief.

See an endometriosis specialist if you have:

  • Severe period pain not relieved with over-the-counter medications.
  • Period-related pain in other areas, such as the bowels or urinary tract.
  • Family history of endometriosis.
  • Persistent pain after endometriosis surgery.
  • Persistent deep sexual pain unexplained by a gynecologist.
  • Chronic infertility issues with a history of dysmenorrhea.

The importance of minimally invasive surgery for endometriosis

With minimally invasive surgery, small incisions and assistive devices overcome the necessity for the large incision required for open surgery. The differences between the two are evidence- based: with the former, patients experience less pain and minimal blood loss and have a faster recovery and a better cosmetic appearance. Minimally invasive surgery can also lead to a more accurate diagnosis. For example, endometriosis on the diaphragm cannot be seen during an open operation if the incision is in the lower abdomen; however, with a small incision and a camera, lesions on the diaphragm can be found and treated in one procedure, along with lesions in other parts of the abdomen.

New treatment options for endometriosis

Treatment for endometriosis can be complex, and women may experience significant frustration, pain and even depression as a result.  While endometriosis is not curable, surgical removal of endometriosis lesions is an important part of a patient’s journey. Unfortunately, many women undergo multiple procedures without significant relief of their symptoms.

Because complex endometriosis can involve any organ in the body — and because it is considered a chronic disease that requires long-term treatment — it is critically important that women with this condition seek out a team with multi-specialty experts (colorectal surgeons, urologists, thoracic surgeons, etc.) like the ones at Texas Children’s Pavilion for Women. Women with endometriosis very often have co-existing diseases such as irritable bowel syndrome, interstitial cystitis, pelvic floor muscular pain, pelvic congestion syndrome, etc. In these cases, women should be aware that taking care of endometriosis maybe not result in complete pain relief.

Texas Children’s Hospital welcomes the opportunity to address concerns women may have about endometriosis. Dr. Guan and his endometriosis team, Dr. Tamisa Koythong and Dr. Joseph Nassif, can be reached at 832-826-7500 or online at the Pavilion for Women.

Dr. Xiaoming Guan, division chief and fellowship director of minimally invasive surgery at Texas Children’s Pavilion for Women, is an expert in minimally invasive surgery for endometriosis. With multiple publications on minimally invasive surgical treatment of endometriosis to his name, he is dedicated to advancing endometriosis care nationwide. He is the first to have performed several unique endometriosis procedures that help women recover faster with less pain than traditional open surgeries.