Endometriosis Awareness Month: Advancing the Detection and Treatment of an Underdiagnosed Disease

“I was drawn to research regarding endometriosis because it was and remains a poorly understood area of women's health, and patients are vastly underserved.

Often patients presenting with pelvic pain are told, 'It's all in your head, or it's normal.’ Every patient with pain deserves a full evaluation and proper treatment. Our work has expanded the available hormonal treatments for women with endometriosis and pelvic pain.”

Mark Hornstein, MD
Director, Reproductive Endocrinology Division
Kosasa Family Endowed Chair in Obstetrics and Gynecology
Brigham and Women’s Hospital

“I found the statistic of 1-in-10 women suffering from endometriosis to be mind-boggling. The realization that endometriosis is so common, yet so understudied, made me want to know more.

A significant takeaway from my research is that non-invasive imaging techniques, specifically pelvic MRI and transvaginal pelvic ultrasound, can be used to diagnose endometriosis.

The thought that endometriosis is only a gynecologic disease is not true. Endometriosis can affect the urinary system, gastrointestinal system, lungs, diaphragm or practically any organ in the body. My hope is that with non-invasive imaging tools, we can detect this disease earlier and help improve the quality of life of these young women as they seek treatment earlier.”

Anu Shenoy-Bhangle, MD, FSAR, FSABI
Medical Director, Abdominal Radiology
Massachusetts General Hospital

“I became interested in studying menstrual pain, since it’s such an important issue for many, but we know surprisingly little about what causes it and why it’s a risk factor for chronic pain.

My research has shown that menstrual pain is a complex experience associated with many different factors, including the brain and central nervous system, not just the uterus.

Many people assume that laparoscopic surgery (the surgical removal of endometrial tissue overgrowth) is the only treatment for endometriosis. However, most individuals benefit from a multidisciplinary approach. Treatment for endometriosis is not one size fits all.”

Laura Payne, PhD
Director, Clinical and Translational Pain Research Laboratory
Associate Psychologist, Adult Outpatient Services
Massachusetts General Hospital

“I'm interested in how female-specific factors like endometriosis might affect overall long-term health, particularly when it comes to heart disease and stroke.

We have found that women with a history of endometriosis, especially the more severe forms, seem to have a higher risk of heart disease and stroke in mid-to-late life than women without endometriosis. Women with a history of endometriosis should work with their clinicians to focus on cardiovascular risk factors screening and risk reduction.”

Kathryn Rexrode, MD, MPH
Chief Academic Officer, Brigham and Women’s Hospital
Chief, Division of Women's Health
Brigham and Women's Hospital

“Endometriosis is common and can start in early adolescence. We have found that if we diagnose and treat endometriosis and validate a woman's experience, she can receive treatment to suppress the disease's progression, preventing pain and reducing the risk of infertility.

Pain with periods that does not respond to hormonal therapy is not normal. Women should not feel that they need to live with the pain.”

Marc Laufer, MD
Chief, Division of Pediatric and Adolescent Gynecology
Brigham and Women's Hospital

“I was motivated to work on endometriosis research after working on a consortium project showing that women with endometriosis have a two-fold increase in some types of ovarian cancer. I wanted to find out more about endometriosis to better understand what contributes to this increased risk.

Our work looking at blood biomarkers in adolescents and young women with endometriosis suggests that dysregulation of immune pathways and inflammation are an important component of endometriosis. We also observed differing blood biomarker profiles by different types of pain presented by endometriosis patients.

Endometriosis is not just bad menstrual cramps. Patients with endometriosis have varying types of pain that sometimes align with the menstrual cycles but often do not.”

Kathryn Terry, ScD
Epidemiologist
Brigham and Women's Hospital

“When I started my fellowship in reproductive endocrinology and infertility, I realized how much of an impact that endometriosis had on women struggling to conceive.

For patients with ovarian endometriosis, surgery to remove the cysts leads to diminished ovarian function. Minimally invasive approaches can be used to avoid major surgery and will still reduce ovarian cyst size and enhance ovarian stimulation as a patient undergoes IVF.

A negative ultrasound does not mean you do not have endometriosis. Diagnostic imaging and newer algorithms using ultrasound and MRI imaging have helped diagnose endometriosis much better than before, but it is still not perfect.”

John Petrozza, MD
Chief, Division of Reproductive Medicine and IVF
Director, Massachusetts General Fertility Center
Massachusetts General Hospital

“I was drawn to advancing research and clinical care that specifically addresses the unique cardiovascular risks women face, ensuring that sex-specific factors like endometriosis are integrated into cardiovascular risk assessment and management.

I frequently get asked, ‘How does a gynecologic condition like endometriosis increase cardiovascular risk?’ The answer lies in the shared mechanisms between endometriosis and cardiovascular disease, including chronic inflammation, oxidative stress, and endothelial dysfunction.”

Maria Pabon Porras, MD
Cardiologist, Heart and Vascular Center
Brigham and Women's Hospital