Talk:Endometriosis/Archive 1

Numbers

The numbers given in this entry are mutually incompatible. I realise that estimates vary wildly but some effort should be made to reconcile the percentage and numerical estimates - 89 million is waaaay less than the 20% of women suggested in the same sentence. Anyone got time to do the research necessary to come up with a sensible range of possible numbers and percentages? I haven't, alas. --Oolong 07:37, 5 October 2007 (UTC)2007

Numbers Part 2

Just wandered in looking for information, and the numbers are the first thing that caught my eye and damaged the credibility of the article. With an estimated population of about 6.2B on the planet, and approximately 51% female, this would suggest approximately 600M women have it if 1 in 5 are affected. Article cited in [1] claims 3-10% of *reproductive women*, 25-35% of *infertile* women. Anyway, I'm anonymous, not familiar with guidelines--expect someone will edit this out, but IMO it really hurts the credibility of this article... My best guess is the 1 in 5 actually means 1 in 5 fertile females. —Preceding unsigned comment added by 68.35.135.191 (talk) 08:40, 24 May 2008 (UTC)

Numbers fixed. --Kjoonlee 23:52, 19 August 2008 (UTC)

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excising endometriosis for more complete relief----

There has not been much written on completely excising (cutting) ALL endometriosis from ALL areas. Two very good resources for this type of procedure are the Center for Endometriosis Care(CEC) in Atlanta, Georgia(Dr. Albee and Dr. Sinervo) and Dr. Redwine with his extensive research in Oregon. I can testify that after 12 years of suffering from endo, I researched and found that totally removing all traces of endo produced very possitive, long term relief. Also, a laporoscopy is the only definite means of diagnosing endometriosis as all stages of endo(stages I,II,III and IV)can vary in symptoms depending on where the endometriosis is and adhering to. I personally had stage IV, had this procedure(complete excision)done and have been endo pain-free for 2 years. Pain medications, estrogen therapy, hormone removal therapy(lupron) do not remove endo from your body, it may mask symptoms for a time. Even hysterectomies will not help if you do not have endo in or on female organs. I had endo in other areas(bladder, ureters, colon, pelvic wall) that a complete hysterectomy DID NOT remove or help the endo "die off", as many doctors falsely believe. --Christi222 19:14, 26 January 2007 (UTC)Christi McDonald

I would like to concur with Christi222 as a person who has had excision surgery. I have been pain free for almost two years now since having the endometriosis plastered throughout my pelvis thoroughly excised by specialist. I did not have a hysterectomy either and would like to know where it has been shown that a hysterectomy is a treatment for endometriosis. I have heard accounts from numerous women who have had a hysterectomy and it did NOT cure their endo. ---- sassygirl1968

Yes, excision with biopsy is the only way to offcially diagnose endo and the only effective long term treatment to date. Laser and cautery vaporization and ablation only remove the surface of the disease, and leave the "roots" to continue to regenerate. Hysterectomy with bilateral salping oophrectomy is not a cure. Endometriosis lesions produce their own hormones, so will continue to proliferate on their own if not removed even if the ovaries and uterus are removed. It is appalling that this article lists ablation and vaporization as "treatments" when all it does is create adhesions and scar tissue, leading to more pain and not treating the disease at all. Barbiegirl1983 (talk) 05:09, 2 March 2009 (UTC)

NSAIDs

How can NSAIDs increases the flow when they thick out the blood, causing decreased flow. And trust me, they DO work for endometriosis. Nothing does. :(

NSAIDs don't work for endometriosis pain at all. They are great for mild pain, but the severe pain caused by endo needs something stronger. Barbiegirl1983 (talk) 08:06, 23 February 2009 (UTC)

They are not necessarily targeting only pain with NSAIDs. The hypothesis is that there is a feef-forward loop of COX-2 expression, PGE2 production upregulating local tissue specific estradiol aromatase. So in theory NSAIDs could break one element of this chain, however I am not aware of any results showing they actually do that. Richiez (talk) 19:13, 21 April 2010 (UTC)

Food and nutrition

I would like to suggest that we have a section on the main page regarding food and nutrition. I think that it would be nice to have a section where women can express their personal experiences with different types of food products. For example, I have noticed an increase in pain after consuming certain types of red wine as well as certain types of ice cream. I think that a section where people could list these types of triggers and could comment on them so that we could complile a list of common offenders. This is the perfect place for public discussion, as it is for the people and by the people. Please comment on this before I re-post regarding food and nutrition. Thanks.Disneytina79 (talk) 01:55, 27 October 2008 (UTC)

I have removed the section saying that avoiding white bread helps endo. There is no proof of this. Also this section focused entirely on PMS- PMS is not to do with endo, it's a seperate condition. Women with endo are not any more likely to have PMS. In fact given that most of us have treatments that stop periods altogether it's not much of an issue. LouiseCooke

Although Louise is correct about white bread, there is evidence that wheat has an effect for some people. This is based on one of the theories of endometriosis being an auto immune disease. If then your immune system is compromised by an intollerance to wheat then by removing wheat from your diet your immune system is no longer stressed and your body is no longer stressed. Part of the enigma of this disease is that the pain a person suffers is not linked to the amount of endometriosis a person has. Most people may not care if they have endometriosis or not, but they do care about the pain and other symptoms they suffer with.
--Ccfd9 14:46, 30 March 2007 (UTC)

White bread is a very common pain trigger for women with endometriosis. Many patients are intolerant or allergic to wheat and yeast, both of which white bread contains. It is also very inflammatory and contains no fibre contributing to bowel pain. Barbiegirl1983 (talk) 08:08, 23 February 2009 (UTC)

I rewrote the article because:

• The previous endometriosis write-up was based on a government publication that was directed to a patient population.
• Much of the stuff was redundant or is now better explained in Wikipedia's cross-references.
• The article (like the goverment publication) addresses the reader as "you".
• It contained a section that may have been taken from other parts of the internet: The Chapter about Dr.M. and allergy I found in the doctorslounge (http://www.thedoctorslounge.net/clinlounge/diseases/gynecology/endometriosis.htm), however Dr.M. apparently never published her research in a peer-reviewed article. I do not know if this section is original to Wikipedia.
• References steering readers to specific physician services in the links do not belong here.

I hope that this more concise article can be further improved. It still needs more work. Ekem 17:49, 1 Mar 2005 (UTC)

Can any sources be cited to substainiate the idea that endometriosis can be related to 'women who wear army boots' ?

===="Army Boots"??? You're joking, right? A quick Google search regarding Endometriosis+"army boots" results in nothing. And this is the first time that I have ever heard it mentioned... Do you have any links or anything where this is being talked about?

I would like to see more information added regarding the Dioxin theory or connection. You can get more information regarding this here: http://www.endometriosisassn.org/environment.html RuthB 23:30, 26 March 2006 (UTC)

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I felt this sentence was a little clunky, and have altered it: "Infertile Women present with endometriosis may lead to fallopian tube obstruction despite no history of "endometriotic type" pain". Also I have altered it so that it states subfertility is common- few women, even with endo, are completely infertile?

Needs a new definition?

The definition in this article, "the tissue lining the uterus is found outside of the uterus", while apparantly correct, is nonetheless highly problematic. Besides being completely meaningless in the context of male endometriosis, the Epidemiology section points out that issues can occur in all sorts of places. This issue should be cleared up, but I have not the skill to do it. Vectro 01:51, 21 May 2006 (UTC)

More on male endometriosis?

Endo in males is extremely rare, and usually concurrent with estrogen therapy for prostate cancer. Current theory is that the estrogen triggers cells latent since sex differentiation in the womb. I don't know enough to edit this article, but perhaps someone will.

I have removed reference to the prostate gland in the lead. Talk about your "distant sites", the rest of the lead mentions only women, and the reader upon encountering a prostate gland thinks "What the...?" The idea of male endometriosis is so surprising that it rates a full paragraph, if it indeed exists, or nothing. I was not able to so much as confirm the existence of it, so out it goes until somebody can cite a source. --Milkbreath (talk) 11:31, 1 April 2008 (UTC)

Ovarian Removal vs. Non Ovarian Removal

Coming from someone who has lived with Endometriosis, I have a hard time beleiving that the removal of both ovaries is necessary. I had a hysterectomy 1 yr ago, and I kept both of my ovaries, and have had no problems to date. I felt it was best for me to keep my ovaries, considering my age<30,r/t not wanting to cause unnecessary bone deterioration, and the fact that I didn't want to go through menopause completely at my age. Granted, I have had a few hot flashes, but have had nothing more serious, nor have I had the mood swings or night sweats commonly associated with menopause. The best thing that I can say, is that since my hysterectomy, I have had no pain that I would previously assocaite with menstrual cycles or endometriosis. I am able to do things I wasn't able to do before, and the best thing is, I still have my ovaries. So, if this is true in my case, as well as in others that I know of (women keeping their ovaries)what makes us different? Holy Crap Batman

It could be possible that a lot of your pain came from Adenomyosis- endo in the wall of the womb. In your case a hysterectomy would solve the problem. It doesn't work for everyone, in many cases where the ovaries are left the endo continues to grow. I'm glad it has worked well for you though! LouiseCooke

Should there be a section called "famous women/people who suffer/ed from endometriosis?

I believe Marilyn Monroe and Michelle Dewberry (winner of series 2 of The Apprentice (UK)) both suffered from this disease. It's specifically mentioned on Marilyn's page, and Michelle has stated in that she has this in interviews. [1] and [2]--Athcnv 19:50, 11 April 2007 (UTC)

Endometriosis, Emiko Hsuen and JoyandFreedom

There was some discussion above about a lady claiming to be cured of endometriosis through some Shaolin Qigong, i've 'excised' the entire chunk and put it under a new heading. As follows. Anyway my two bits, Emiko, I really do believe your account and wish you all the best, but honestly, unless you hold a randomized clinical trial involving thousands of women and find consistently good, reproducible results, this information isn't really very useful. Also, your claim links to your webpage, joyandfreedom.com which seems to market some courses. That's a conflict of interest right there. Wikipedia is for information and knowledge, not selling out courses. Though your intentions may be good, this isn't really the place. Squiggle 04:14, 15 September 2007 (UTC)

Original post as follows: Hi, I have no prior experience to contributing to wikipedia but for the first time there's something that I think should be added. A teacher in the kung fu school that I'm part of has been cured of Endometriosis. She's documented exactly how it was done at this website http://www.endofendo.com/ . She used a "complementary medicine" called Shaolin Cosmos Qigong. If someone would add this link to the wiki page for others to discover that would be fantastic, thank you. James Redfern.

Sorry, I don't think we should add this as it is not in any way scientifically proven. Nothing has appeared in reviewed journals etc. The case of one woman out of 89 million claiming a cure is a little suspect. Also, reading the story on her website it is possible the surgery, Zoladex and Lupron shrank away her endo so it was no longer noticeable. There are many documented cases of this happening. Having endo removed surgically and then treated with hormones can stop it growing back in some women. I suspect this woman is one of those. Wikipedia is supposedly academic and until proper academic proof of this 'cure' appears, I do not believe it should be mentioned. User:LouiseCooke

Hello. My name is Emiko Hsuen, and I am the woman who has been referred to in the paragraph above. After a close reading of the medical documentation presented on my website at http://www.endofendo.com, it will be apparent that the time period is 10 years between the ingestion of Zoladex and the discovery of the nonpresence of endometriosis by the surgeon. It should be noted that not even scar tissue was present in the body during the time of surgery. Also, please note that there is a difference between an 'anecdotal story' and a 'medical case study'. My account is defined as a medical case study - a rare occurrence, since most women would not voluntarily choose to undergo surgery just to verify that they have recovered from endometriosis. As for 'anecdotal stories', I personally know of at least 3 other women who were diagnosed with endometriosis, but have since become completely pain-free through the practice of Shaolin Cosmos Qigong. Their accounts are not medical case studies because their recovery has not been confirmed by a licensed medical practitioner. Emiko Hsuen.

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Original Research justification

I've tagged with several claims made in the article because, while they may be true, they lack the citation needed to support statements made in such a conclusive manner.EdgeOfEpsilon 16:31, 2 December 2007 (UTC)

Good for you! Seconded. The numbers in the lead are much lower than the cited material under Frequency. The age band is also very narrow. Finally, the figures are not in the reference provided. Cheers. Alastair Haines 10:01, 3 December 2007 (UTC)

A little over a year seemed like more than enough time to delete the statements marked as "citation needed." I deleted those, and added "citation needed" tags to the other unreferenced statements in this section. If they also fail to generate references, they will also be deleted. --Transity ^{(talk • contribs)} 00:59, 7 April 2009 (UTC)

Lupron depo shot

No one has talked about how the lupron depo shot has worked on suppressing endometriosis or how it works for endometriosis. Removing specific hormones from your body helps reduce the chances of the regrowth of endometriosis. No one has also even touched on the benifits or the side effects of the shot. The lupron depo shot is given once a month for either 3 to 6 months depending on your dosage.--Daniellem429 (talk) 22:42, 16 March 2008 (UTC)

Per WP:MEDRS, a scientific journal article would be preferred over a website. WLU (talk) 17:33, 21 March 2008 (UTC)

As far as my experience with the Lupron injections- they were of no value whatsoever. — Preceding unsigned comment added by 70.44.196.241 (talk) 21:34, 5 January 2012 (UTC)

Pregnancy

In the opening preface of the article, the line '(usually around 30 to 40 years of age who have never been pregnant before)' should be deleted. There's an ill-concieved notion that getting pregnant eradicates the disease when all it really does is slow the progress due to a shift in hormonal balances (as it does with Lupron and birth control). If a woman with endo can get pregnant in the first place, there's a great deal of anecdotal evidence suggesting that symptoms can be alleviated but they do *not* vanish. While the phrasing seems innocuous enough, perhaps even unrelated to this mistaken belief, it's dangerous to even insinuate something that doctors mistakenly fall back on. Pregnancy has nothing to do with whether or not endometriosis is found in a patient. Refer to http://www.endometriosistreatment.org/html/question8.html for more information. If this link violates copywrite feel free to strike this comment from the list, but I do feel very strongly that the wording is in dire need of being changed. It's misleading and has no basis in fact, so what's it doing up there? This disease is misunderstood enough. 204.176.49.45 (talk) 17:28, 21 March 2008 (UTC)

Anecdotal evidence is not a reliable source, if the statement in the lead is unjustified in the text below, per WP:PROVEIT it can be removed, but any replacement claim should be justified by medically reliable sources. WLU (talk) 17:33, 21 March 2008 (UTC)

Origins / Causes

Currently there is a section of 'theories of origins', followed by a section of 'causes'. The two ideas mentioned in the first are repeated in the second (though with extra possible causes). Should these two sections be one, or am I missing something? 198.28.92.5 (talk) 13:08, 6 May 2008 (UTC)

Treatment Edits

{{request edit}} I have a relationship to this research. I am aware of Wikipedia's policies and guidelines and will abide by them. I am volunteering information for this talk page only, and ask for Wikipedians’ help in determining if these edits are suitable for the page. Please consider adding “9.4 Physical Therapy” to the treament section.

Physical therapy [3] has long been an adjunct to standard medical care, assisting patients and their physicians to achieve rehabilitative goals after an injury, surgery, disease, or other trauma. Physical therapists work to decrease pain and restore normal movement and function in the body.

Two pilot studies on the effectiveness of a manual physical therapy (Clear Passage Therapies), in treating pain and dysfunction associated with endometriosis, were presented to the American Society of Reproductive Medicine (ASRM) [4] at the annual meeting in 2006. The abstracts published in "Fertility and Sterility" are summarized below:

“Treating endometriosis pain with a manual pelvic physical therapy” [1] Eighteen (18) patients with endometriosis and pain during the three phases of the menstrual cycle, or intercourse pain received the 20-hour program of manipulative physical therapy. The results using The Wilcoxon Sign-Rank Test (2-sided) showed a statistically significant improvement in dyspareunia (intercourse pain) and in the total difference at all three phases of the cycle, including pre-menstruation, menstruation, and ovulation (P = 0.014). Decreased menstrual pain was significant (P = 0.008), and decreased intercourse pain was significant (P = 0.001).

“Improving sexual function in patients with endometriosis via a pelvic physical therapy” [2] Fourteen (14) patients with endometriosis and decreased sexual function received the 20-hour program of manipulative physical therapy. The results using The Wilcoxon Sign-Rank Test (2-sided) showed a statistically significant improvement (P =<0.001) on the full scale score, and all six individual domains: Desire (P = 0.011); Arousal (P = 0.004); Lubrication (P = 0.001); Orgasm (P = 0.004); Satisfaction (P = 0.005); and Pain (P <0.001).

References

1. Wurn LJ, Wurn BF, King CR, Roscow AS, Scharf ES, Shuster JJ. Treating endometriosis pain with a manual physical therapy. Fertil Steril. 2006; 86 (Supp 2): S262. Abstract.

2. Wurn LJ, Wurn BF, King CR, Roscow AS, Scharf ES, Shuster JJ. Improving sexual function in patients with endometriosis via a pelvic physical therapy. Fertil Steril. 2006; 86 (Supp 2): S29-30. Abstract.

Research6840 (talk) 16:16, 24 October 2008 (UTC)

These edits are neutral and reliable sources. As no opposition or discussion has occurred since this talk was posted a month ago, I moved the edits to the page. Research6840 (talk) 22:32, 18 November 2008 (UTC)

I have removed the section in question from the article because: The section concerning a research topic that was presented at a scientific meeting is just a pilot study and thus preliminary, it has apparently not been published in a peer-reviewed journal, and it is not part of standard therapy. Nevertheless, as it may be of some interest, I placed a sentence about physical therapy into the treatment section with the reference.Ekem (talk) 00:13, 19 November 2008 (UTC)

I undid the 'request edit' template above because User:Ekem has already responded to the request. EdJohnston (talk) 04:02, 6 January 2009 (UTC)

stages

There's a reference made to there being four stages of endometriosis, but they aren't outlined or explained anywhere. Seems like something there should be a section or subsection on. —Preceding unsigned comment added by 64.28.213.114 (talk) 01:32, 25 October 2008 (UTC)

The staging of endo only relates to the amount of physical disease present as related to fertility/infertility. It has nothing to do with the amount of pain or serverity of symptoms, or sometimes even the possibility of pregnancy as women with minimal visible endometriosis can have massive amounts of inflammatory hormones causing spontaneous abortion. It would thus be logical to think that someone with a diagnosis of stage I endometriosis with severe pain might be not be taken seriously because their visible disease "is minor". It is not like cancer staging where the higher the number the more severe the disease. Barbiegirl1983 (talk) 03:44, 25 February 2009 (UTC)

You are right about staging having nothing to do with the amount of pain or severity of the symptoms. You can have no symptoms and have severe (stage IV) or have severe pain and only have stage I. As far as the stages go; At stage I you have a good chance of having kids up until stage III, at stage IV your chances are slim even with intervention. The higher the number the more severe it is, not meaning you have more pain. (talk) —Preceding unsigned comment added by 205.240.144.172 (talk) 03:42, 4 November 2009 (UTC)

Clean-up 11/2008

I tried to clean-up the article, adressing some of the concern voiced above, and removed some sections placing them here with my rationale for doing this.

• "It is hypothesized that excess estrogen levels may be measured by a female taking her morning temperature (with a thermometer showing a tenth decimal) at the same time each day for a month or two. A normal woman's body temperature varies from 97.5 to 98.5 degrees Fahrenheit (36.3 to 36.9 degrees Celsius), however it is hypothesized that someone with endometriosis may see temperatures of 97.0 to 98.5 °F (36.1 to 36.9°C). The lower temperatures signify the estrogen phase of a normal female's cycle, therefore it is logical that women with excessively lower body temperatures, may have an excess of estrogen, thus endometriosis. Research is needed to determine the reliability of using waking temperatures to diagnose endometriosis and its severity."

There is no medical refences and this is not current practice; it is a conjectural proposition.

• "Most women have some degree of reflux menstruation, yet only 10-15% of them have endometriosis; Endometriosis follows reproducible patterns of distribution within the pelvis, and older women do not have more widespread disease than younger women as one would expect if reflux menstruation was truly the origin; More than 700 gene differences exist between the tissue found in endometriosis and native endometrium, which should not be the case if endometriosis is an autotransplant disease formed by reflux menstruation; Conservative surgical excision of endometriosis (removing the disease without removing the uterus or ovaries) produces a cure rate of approximately 60% which would be impossible if Sampson's theory were true, because every month new endometriosis would form as long as a woman kept menstruating; Sampson's theory cannot explain endometriosis of distant sites including the brain, lungs, and skin."

These are some unreferenced but possibly reasonable objections to Sampson's Theory, however nobody would claim that ST attempts to explain all cases of endo, or would operate in a vacuum without the involvement of other co-factors. Further, there are arguments that validate Sampson's concept and they have been summarized by Speroff L et al, Clinical Gynecologic Endocrinology and Infertility, Sixth ed. Lippincott Williams and Wilkins 1999, p1057-8. A discussion of the pro and con of these theories may be too extensive for the article.

Samspson's Theory doesn't make sense at all. How do young girls/teens who have never had a period before or men have endometriosis? If it was also the case, one would expect to see severe vaginal and cervical endometriosis in many women due to monthy exposure to menses. Hysterectomy is not a cure because endometriosis does not originate from the uterus. Endometriosis lesions also produce their own estrogen, so the removal of the ovaries does nothing in the treatment of the disease. I have intramuscular abdominal wall endometriosis in addition to pelvic endometriosis which started before I had my first period. How does Sampson's theory explain that? It can't, because it is wrong. http://www.endometriosistreatment.org/html/reprint3.html Barbiegirl1983 (talk) 05:21, 2 March 2009 (UTC)

It is simplistic to try to invoke Sampson's Theory in each and every case. And nobody would considere it to be the only explanation or an explanation that would not work together with other factors, perhaps so that the reflux of menstraul debris triggers a peritoneal response (=combination of Sampson's & metaplasia theories). Redwine in your reference postulates that endometrial cells would have to stick to the peritoneal surface in order for Sampson's Theory to be possible. He does not mention that the menstrual reflux consists of much more than endometrial cells, namely menstrual debris with blood and cytokines and cell organelles and immune factors and more. So even if there would be not direct endometrial transplantation, the reflux model as such has not been disproven.Ekem (talk) 23:09, 14 May 2009 (UTC)

• "Human papilloma virus may have an effect upon predisposed conditions."

No evidence within this context.

• "A small-scale 1995 study by University of Louisville School of Medicine suggests "an association between the occurrence of natural red hair and those factors that lead to the development of endometriosis"."

I would like to see more evidence than one small scale study.

• Re laparotomy: "This approach does not enable the surgeon to access all areas of the pelvis and magnify small areas of endometriosis; a laparoscopic approach is therefore usually more effective. Endometriosis facts

The surgical section was revisited and spam based material removed.

Ekem (talk) 17:53, 18 November 2008 (UTC)

Common Contradiction

"Endometriosis [...] is a common medical condition" "[...]it has been estimated that it occurs in roughly 5% to 10% of women." I would argue that these two statements are contradictory; unless someone would like to explain why they are not, I believe an edit is in order. Someone with more knowledge than me regarding this can make the edit if it is necessary. —Preceding unsigned comment added by Carbonhazard (talk • contribs) 20:37, 12 December 2008 (UTC)

WP:MEDRS

I have reverted a recent change, and here is my rationale. An editor, Barbiegirl1983, recently added a number of new medical claims to the article, with the edit summary, "Changing inaccurate and outdated information, adding endometriosis awareness, adding link". The full name of WP:MEDRS is Wikipedia:Reliable sources (medicine-related articles). If our information is outdated (which is no doubt possible) it needs to be shown from published sources, preferably in peer-reviewed journals. The new information that was being added had no sources that I could perceive. In addition, the proposed link to DrRedwine's site should be discussed on the Talk page to get consensus before adding it to the article.

It's quite possible that some of Barbiegirl983's information may check out as correct, once the references are found. This is necessary work, though. EdJohnston (talk) 17:42, 23 February 2009 (UTC)

All of my changes are correct, the reversian just fuels the many misconceptions (even among most obgyn's) and delays proper treatment. Look into Dr. Redwine's (leading endometriosis specialist worldwide) work and research, or ask the Endometriosis Research Center, which is the leading research advocate and authority for endometriosis. There are plenty of study sources there, however I lack the computer coding skills and the time to site all of them. I am terribly disappointed that you continue to have an "encyclopedia" article full of outright misinformation and myths. It is akin to having an article on the earth being flat or or that humans require oxygen. One of the recent "most published" endometriosis articles, apart from telomerase or auto-flourescent laparoscopy (which are both very valid studies that should be part of the article as well), was the study that tampon use and frequent sex prevents endo. If this were the case, we should have young girls having sex and wearing tampons during elementary school so they can prevent the onset of endometriosis during their teens (the most common time to present with endo symptoms, although most of us are dismissed until our late twenties or thities when we struggle with infertility. This should also be the case for men at risk for prostate cancer and subsequent hormonal therapies leading to endometriosis in men. I suggest you read the ERC's response letter to this very published and very logically flawed study and recognize that publicity does corolate to accuracy. They are two very different concepts to a very under-recogized and misunderstood disease. You might want to learn a little bit about endometriosis yourself Ed, before changing someone else's accurate and up to date work. Barbiegirl1983 (talk) 23:30, 24 February 2009 (UTC)

Editors are expected to provide references for their own article additions. Please don't try to delegate this work to others. If you are too busy to take care of that now, come back when you are able. We do invite your efforts, but we need to follow WP:MEDRS. If you have the references and just need help in formatting them, you can ask us for assistance. EdJohnston (talk) 03:56, 25 February 2009 (UTC)

I actually did provide my references above and linked. I am not "delegating" anything and am incredibly offended that you accuse me of that. I am appalled that you consider the amount of publicity generated by a study to mean that it is accurate, because that is not at all the case. You really need to do some SERIOUS research yourself about this disease Ed, because I am not sure what you have to contribute to on the topic of endometriosis. You clearly know nothing about the disease, and are so concerned with silly rules and posting inaccurate information that it prevents endo patients from recieving the information they desperately need. You are a sad, sad man Ed. I encourage you to spend 1 day in my shoes. Try being in what is equivalent to end stage labour pain about 95% of the time (you wouldn't last an hour). Then you might have something to contribute. But until you have a biopsy confirmed diagnosis of endometriosis (yes, I did say biopsy confirmed unlike the article), you need to understand that you have absolutely NOTHING to contribute to the subject of endometriosis. Barbiegirl1983 (talk) 04:58, 2 March 2009 (UTC)

You have leapt to about a dozen unwarranted conclusions in the above posts. Please refrain from personal attacks, and focus on the content. Both of Ed's posts have been perfectly reasonable in tone; the problem seems to be that you are unfamiliar with our standard for verifiability of content using reliable sources. No one has said anywhere that the amount of 'publicity' related to a study carries any weight; what has been said is that specific assertions need to be cited to published sources, preferably from peer-reviewed publications. Maralia (talk) 05:16, 2 March 2009 (UTC)

I don't respond well to people deleting my accurate work when I am in severe pain. I am sorry, I have endometriosis, and, as an actual patient am passionate about people receiveing accurate information, not half the bs that is article sites. The sad thing is that I know more about this disease than most gyns do. Don't take that as arrogance, I am sorry to say it is the truth. It is persoanl, as he was attacking me and assuming ridiculous notions. He did say: "If our information is outdated (which is no doubt possible) it needs to be shown from published sources, preferably in peer-reviewed journals." and "don't try to delegate this work to others". So yes, my being offended by Ed is 100% justified. I am focused on the topic of creating an accurate article instead of continuing to spew the MANY myths about this disease to the general public. Have you read some of the more public peer reviewed studies out there? Again, a reference to the sex and tampons preventing endo study that was published by a very well respected medical journal and was well recieved by gyn peers. The inherent problem in this is that most gyns know about as much as this article when it comes to endo. There are very few actual endo specialists to review it. So being "well received by peers" is absolutely redundant for this particular topic, and one really has to focus on the sources coming from the very few actual endometriosis specialists. Again, both valid resources to my changes (being Dr. Redwine's work and the Endometriosis Research Center) were sited. I am not sure how that is a problem, as the resources and studies are there. Barbiegirl1983 (talk) 05:34, 2 March 2009 (UTC)

In general, Wikipedia's medical articles should be based upon published, reliable secondary sources whenever possible. Reliable primary sources can add greatly to a medical article, but must be used with care... (see Wikipedia:No original research) and Wikipedia:Reliable sources (medicine-related articles).

Having said that, Wikipedia also encourages everyone to dive in and try your hand at writing an encyclopedia article. I saw some real potential in your work. You stepped over the line, that's all. But to your credit, you didn't go way, way, way over like others. You almost have the correct voice. Keep trying. Sincerely, Danglingdiagnosis (talk) 00:22, 7 April 2009 (UTC)

How is providing accurate inforation in the mess of endometriosis myths as it stands now including links to the sites publishing the studies that prove exactly what I am saying "crossing the line"? I am not going to keep wasting my time correcting a largely inaccurate "encyclopedic" article on a disease Iknow inside out when someone who doesn't know a fraction of what I do about the disease deletes it. I personally just had major endometriosis surgery and really don't have the energy to keep fixing the article over and over again when ignorant people keep reverting it. It is ALMOST as futile as laser ablation or cautery at "treating" endo. The reality is that most doctors know very little about endo, most of their knowledge being based on myths. It is a massive public disservice to continue "informing" the general public about a very serious disease and giving them all the wrong information. It is like the Pope telling people in Africa that condoms cause AIDS. Shameful! Barbiegirl1983 (talk) 04:12, 22 April 2009 (UTC)

Holding yourself up as a primary source of information is exactly the wrong thing to do at Wikipedia. The simplest way to be a wikipedian is to find a peer-reviewed article (not an article written by a single doctor and published on his/her own web-site) and incorporate it into wikipedia using your own words. Write it in a way that uninformed people, like us, can check your sources. Don't expect us to be experts on the subject. This is not a peer-review journal. None of us are supposed to act like experts. We're wikipedians, not experts. Please read WP:MEDICINE and especially WP:MEDRS If your goal is to initiate a revolution and help change a "myth" held by a majority of doctors, you're probably better off elsewhere.

Are you sure there are a lot of myths out there? Or is it one big myth? If you ask me, the real "myth" is that doctors are able see inside the peritoneal cavity with great clarity. I think most people, including doctors, are quite resistant to the idea that an x-ray or MRI can't see everything. It's a wise doctor who remembers the aphorism used by surgeons: "Never let the abdominal wall get between you and a diagnosis" which is a way of saying that surgeons sometimes need to cut into a person before they can get a clear picture of what needs to be done. If you have suffered for years with endometriosis and no doctor could diagnose you, you've probably frustrated about how hesitant doctors were to do something. I share this frustration, and search for ways to educate people and doctors. Managing uncertainty is not something we do well in western society. It's why I support tort liability reform laws and web sites like Faces of Lawsuit Abuse and Sick of Lawsuits. Googling the words "lawsuit abuse" results in about 145,000 hits.

But really, you almost had the right voice. Pick one thing that you think needs to be mentioned, (or something that you think is a "myth"), write about it, and support your thinking with a good source (probably not a doctor's personal web-site). Yes, it is hard work, and if you can't sit in a chair for hours looking at a computer screen because of your surgery, you probably shouldn't be doing it. It's not supposed to be easy. Don't expect us to do the work for you. It's your responsibility to prove your case with a reliable source WP:MEDRS . And do please note the words written just below the "Save Page" button that sends your work to us to be viewed, "If you don't want your writing to be edited mercilessly or redistributed for profit by others, do not submit it." Yes, it's insulting to be questioned. But as the proverb goes, kites rise against the wind, not with it. In the same way, humans rise to a challenge. Sincerely yours, Danglingdiagnosis (talk) 15:02, 22 April 2009 (UTC)

I am not trying to initiate a revolution, simply provide accurate information in terms that most people would understand. I am an endo expert, I have read so much about this disease it is incredible. There are many, many generally accepted myths by the medical profession at large that are very damaging for patients. That is why a disease that approx 10% of women have takes on average nearly a DECADE to diagnose. A brief list of common misconceptions: Sampson's theory, teens/children/menopausal women/men can't get endo, pregnancy, sex and tampons prevent and can cure endo, laser ablation or cautery are effective treatments for endo, endo only appears as "classical" powder burn lesions, endo can be diagnosed via imaging techniques or laparoscopic visualization, hormonal treatments provide long term pain relief and hysterectomy cures endo and is a good treatment option... I could continue as the myths are vast. I feel that the people contributing to this article SHOULD be experts on the disease or they really have no business working on it. I wouldn't contribute to an article about cars or html coding because I have nothing to offer on the subject. I have much to offer on this one. Here are just a few studies I found that support everything I have said. http://www.ncbi.nlm.nih.gov/pubmed/12372441?ordinalpos=12&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/19358700?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/19165662?ordinalpos=13&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/18510093?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/15749511?ordinalpos=16&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/14642954?ordinalpos=22&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/12351553?ordinalpos=31&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/19274315?ordinalpos=12&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/19200988?ordinalpos=25&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/19136455?ordinalpos=43&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/18991080?ordinalpos=72&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Barbiegirl1983 (talk) 05:21, 23 April 2009 (UTC)

I encourage you to pick a good reference and summarize it for the article. I'm especially interested to know if you can support your claim that it takes an average of 10 years for a patient to be diagnosed with endometriosis? Have there been epidemiological studies done to support that figure? If so, I think it would make a fine addition to this article. Otherwise, if you make statements that are unsupported by references, someone will tag it, like so. It's nothing personal, so don't be offended. We're just trying to draw out what you know along with how you know came to know it. This results in better articles. If you're uncomfortable submitting to this scrutiny, done in good faith, then don't submit your work. Otherwise, welcome to Wikipedia and thank you for contributing. Yours truly, Danglingdiagnosis (talk) 07:03, 25 April 2009 (UTC)

The average woman in the US waits 11.7 years for diagnosis. Hadfield R, Mardon H, Barlow D, Kennedy S. Delay in the diagnosis of endometriosis: a survey of women from the USA and the UK. Human Reprod 1996;11(4):878-80. 96.49.151.103 (talk) 22:41, 25 April 2009 (UTC)

I think this is a good thing to add to the article. You should do so. A further note: It might be more informative if you broke this number down. Some of this time (about 50 percent) is because women (especially young women) delay talking to their doctor about their symptoms. a survey of 4000 women [5] [6] [7] Both halves of this delay is troubling. Hopefully this article will help. Danglingdiagnosis (talk) 04:17, 30 April 2009 (UTC)

I strongly disagree that 50% of women significantly delay seeking medical attention. Endometriosis pain is so severe, bleeding so heavy and OTC analgesics so ineffective that it is a strong motivator for seeking medical intervention relatively quickly. It is very common for teens' pain to be minimized by adults in their life (parents, teachers, school nurse, doctors etc) saying that they are exaggerating the pain they are feeing, but we certainly do not delay medical advice for years. Personally I saw about 8 doctors over 7 years before I found a doctor that actually listened to me and took my symptoms seriously, and that seems to be the most common theme in everyone who I have spoken to about their experiences. http://www.endometriosis.org/press15september05.html Barbiegirl1983 (talk) 04:44, 6 May 2009 (UTC)

Your personal bias is showing a bit more than it ought. I will agree that the figure is better stated as 27 to 50 percent. The reference you gave plus the four I gave (that's FIVE total) all point to a "worrying" delay "before women with symptoms seek help in the first place." Your excellent source from www.endometriosis.org cites a 27 percent delay. (3/11 = 27%) So for you to strongly disagree in the face of this shows, I think, personal bias. Wikipolicy is to remain neutral as much as humanly possible. see Wikipedia:Neutral_point_of_view

Again, I welcome you to Wikipedia and encourage you to keep trying to find the correct neutral voice. You have much to contribute and have done so already. The article is getting better all the time. Thank you for your efforts. Danglingdiagnosis (talk) 20:39, 14 May 2009 (UTC)

27% is a far cry from 50% to most. That is not personal bias, it is almost half of your projected statistic, which is a huge difference. Almost everyone I have spoken to in countless endo support groups did not significantly delay medical attention (6 months or less). Most first went to their school nurse or family doctor for help and were ignored. The few who didn't were told by authority figures in their lives that their pain was normal and to suck it up. It will be impossible to be "neutral" as I have a massive amount of passion on the subject and am personally outraged by the present lacking state of endo knowledge, research and awareness. 96.49.151.103 (talk) 07:22, 17 May 2009 (UTC)

As long as you can see clearly enough to agree that SOME of the diagnostic delay (about 3 to 5 years) is due to a lack of patient awareness, then you'll be fine. Try to see the big picture and lean not solely on your own personal experience. Danglingdiagnosis (talk) 17:41, 17 May 2009 (UTC)

I am also upset that the article again implies that hysterectomy and menopause have a high "cure" rate, because that is not the case. The difference between excision and laser/cautery treatment also needs to be clarified. I will fix them when I am back for holidays. 96.49.151.103 (talk) 07:30, 17 May 2009 (UTC)

Hi, i just wanted to say a coupe of things. Firstly i think that barbie girl should take her arguments somewhere else. I am a young women who is going through the process of being diagnosed with this disease and after reading everything you have written on here all that you have managed to do is confuse me. I now don't know what these so called myths are. Wikipedia is a brilliant site and i use it on a daily basis, but if you are going to be adding to an article, like every one else has been saying, it does need to be backed up with proof. And taking out your anger and showing bad attitude on here is exactly the wrong thing to do. You go on saying about how you have endometrious and that you know everything about it, but have you taken a moment to think about the people who have just been diagnosed and are trying to find out more about it. To be honest i even think that some if the things you have written on here almost has a hint of scare mongery in it. Like being determined that it takes 10years to be diagnosed. Instead of arguing about these things how about writing something usefull like fully explaining the things that you want to say in a calm way and relaxed way. It would help a lot more people out, including myself. I think more respect is needed from you and most definitely a better attiude. Well, thats all i had to say, sorry if any spelling mistakes. Many thanks, Tor It was only a sunny smile and little it cost in the giving but, like morning light, it scattered the night and made the day worth living!!! :-) :-) Tor baker (talk) 08:33, 25 April 2010 (UTC)

Oh please, I don't have a bad attitude, I am just choked at the amount of inaccurate information in the article and having my accurate and sited work erased. Some of the most blatent myths are listed above all the studies I have sited, backing up everything I have said with scientific proof. If you cannot see that, then that is your problem. Nothing I have written is intended to scare anyone; the fact is that the average delay in diagnosis is over 11 years in the US. It doesn't mean that is is always the case, merely the average. The intent on posting that is to hopefully dramatically decrease the delay to a much more reasonable time frame via public education. Knowledge is power, especially when it comes to your health. For me it was about 7.5 to a tentative diagnosis and about 8 for a biopsy confirmed diagnosis. Personally I think the delay is beyond outrageous- I don't care what your health concern is, over a decade in delay between the onset of symptoms and diagnosis is not acceptable. These are people's lives, they need to be treated as such.

Respect is a two way street, if one is treated with disrespect and completely disregarded from the get go, chances are they are not going to feel like being nice back. Common sense. I certainy was't treated with any respect from anyone except Darling Diagnosis, and am certainly not being treated with any respect from you. My attitude is fine, perhaps yours is the one that needs adjusting? People living with severe chronic pain are unlikely to have much patience for people who don't deserve it.

For the record, I spent quite a bit of time rewriting the article while recovering from major endo surgery in a very simplistic and easy to understand way. Unfortunately it was all deleted by uninformed people, and all of my helpful infomation was gone at the loss of fellow endo patients like yourself.

My general advice:

Only see a doctor who specializes in endo and can recognize even the most subtle of lesions. Do not allow them to ablate, laser or vapourize anything. Make sure at your surgery that they are excising ALL visible endo, utilizing autoflourescent laparoscopy if possible, and sending ALL excised tissue to the lab for microscopic review. Also ensure that they remove all blood clots, debris and ensure there is no bleeding before they close. The use of adhesion preventing gels and sprays is also a wise idea to prevent more pain in the future. Know that treatments like Danazol and Lupron etc all have very serious and potentially permanent side effects and only suppress pain short term. Know hysterectomy, tampon use, pregnancy and menopause are not cures. Know that extrapelvic endo is far more common that it is believed. Familiarize yourself with the studies on the cause- and run away from any doctor who believes in Sampson's theory. It is a common excuse for doctors who don't remove all the disease, they can blame their sloppy work on the inaccurate theory. Look into estrogen balancing treatments and dietary techniques, and look into bioidentical progesterone with the help of a licensed naturopathic doctor. It often has the same or better endometriotic lesion suppression and pain relief effects as BCP's and harsher drugs without the negative side effects. Most of all- educate yourself using OTHER resources than just wiki. 24.87.83.145 (talk) 03:54, 4 May 2010 (UTC)

Oh, I almost forgot, ensure during surgery your doctor photographs all endo lesions before and after removal. Having a dvd of the entire surgery is even better if the OR is equipped for that. Don't let them operate without b&a pics. 24.87.83.145 (talk) 03:20, 5 May 2010 (UTC)

The Role of Iron

How shall we characterize the research being done on iron? Is it time to introduce this avenue of research to the article? High levels of intra-abdominal iron, while not causing lesions, may cause them to grow larger. [8] Although this study claims this does not cause endometriosis, a 2009 literature review study goes on to say that iron overload may have "a significant impact on endometriotic-cell gene expression" and play a role in the pathogenesis of endometriosis.

This may be significant and worthy of mention. Perhaps also worthy of mention is the 2006 Belgian study in mice that showed that iron chelation therapy helps proliferation of endometrial cells.

However, I am not an expert. I lack perspective. Is research on mice models worthy of mention in a wikipedia article? Or shall we wait until the research advances to human studies? Danglingdiagnosis (talk) 07:03, 25 April 2009 (UTC)

Adhesions

"(the fibrous bands that form between tissues and organs following recovery from an injury)": Do these bands form after the recovery or during the recovery? Sincerely, GeorgeLouis (talk) 06:08, 6 April 2009 (UTC)

I think it best to say simply "(fibrous bands of internal scar tissue)" and reserve discussion of the causes of adhesions for another time. We don't want to distract the reader from the main point of the sentence. Readers who wish to know more may click the adhesions link. This is why I like to use links and not parenthetical definitions. It's less distracting. Danglingdiagnosis (talk) 12:42, 6 April 2009 (UTC)

But to answer your question... Adhesions form during recovery from surgery. There's a good sentence later in the article that best describes the cause of adhesions: "Endometriosis may trigger inflammatory responses leading to scar formation and adhesions." In other words, adhesions form as a result of various kinds of inflammatory processes, and is not limited only to surgery. When body tissues become inflamed, adhesions are a likely result. The use of anti-inflammatory medication, like celebrex, is one way researchers are considering to prevent adhesions. But all this is described in the adhesions article, isn't it? Oops, I guess it's not there, yet. Soon... Danglingdiagnosis (talk) 12:42, 6 April 2009 (UTC)

My own opinion is that it is less distracting to provide a simple explanation — a phrase or a few words — when an unfamiliar term is introduced, along with a link to the full article for those who want more information. Yours, GeorgeLouis (talk) 18:00, 6 April 2009 (UTC)

I agree with you and stand corrected. I appreciate the parenthetical definition provided by you and 710.21.20.20 and where the word stands alone on the reader's screen, I provided links. The links are sparsely separated from each other. Danglingdiagnosis (talk) 02:18, 13 April 2009 (UTC)

Post -menopause versus post hysterectomy

In the Epidemiology section, there is a statement that is unsupported by the reference given. It states:

"As an estrogen-dependent process, it can persist beyond menopause and persits (sic) in up to 40% of patients following hysterectomy. [9]"

Instead, the given reference states:

"Hysterectomy does not necessarily cure endometriosis. Up to 40% of patients may have evidence of recurrence after 5 years."

Let's not confuse menopause with hysterectomy. The two conditions are not the same thing. Let's also not confuse recurrence with first onset. Danglingdiagnosis (talk) 18:40, 12 May 2009 (UTC)

Potential Causes

I reverted an edit that changed

"In rare cases where imperforate hymen does not resolve itself prior to the first menstrual cycle and goes undetected, blood and endometrium are trapped within the uterus of the patient until such time as the problem is resolved by surgical incision"

to

"In many cases where imperforate hymen does not resolve itself prior to the first menstrual cycle and goes undetected, blood and endometrium are trapped within the uterus of the patient until such time as the problem is resolved by surgical incision"

and added the statement

"Over 75% of women with endometreosis were born prematurely."

No sources were provided to backup either edit. Please provide sources to backup one or both of these claims. --Transity ^{(talk • contribs)} 20:07, 15 May 2009 (UTC)

The first one doesn't really warrant a source but you can't add the second one without a source. It should be removed and if I have time later, I'm going to remove it because I don't see why you would add such a specific statement without posting the source to which you found it yourself. WiiAlbanyGirl (talk) 13:05, 4 July 2009 (UTC)

Look over and edit

This page has some potential issues with (I hate to say it) NPOV and sounds like it was written by a 5th grader. Take below for example:

"There is also the addition of emotional pain; the emotional distress caused by this disease and the emotional pain that many people do not take a woman’s Endometriosis pain seriously. The problem is that it is invisible. No-one can physically see what is wrong with you. On the outside you look perfectly normal. All these things simply build layer after layer of distress and misery. This is the reality for probably millions of women around the world today. And yet most of modern society views the idea of women’s pelvic pain as normal. NORMAL!!! That would be as insulting as saying that asthma is normal in children."

Crmadsen (talk) 05:54, 24 May 2009 (UTC)

That block of text was recently added, I believe. I took the repeat information, and removed it, and moved the other information out of the new sections and into Symptoms. I also tagged where references are needed (none of the added text had any references). It still needs to be edited and properly incorporated into the text around it. --Transity ^{(talk • contribs)} 23:51, 24 May 2009 (UTC)

I completely agree with this comment and would like to take it a step further that the article IS poorly written in many spots, listing things that I have heard are not true (ultrasound being used for endometriosis? Unheard of!) without properly sourcing it (and this happens in several spots). Also, the wiki formatting of many paragraphs (such the treatment paragraph) needs to be completely redone by someone who understands how to write a wikipedia article. Lastly, there are many, many spelling and grammatical errors that make this article very hard to read. It is not worth fixing any one of these errors because someone needs to come in and overhaul the article entirely. I added the cleanup tag but is there something else to add that could encourage a better sense of urgency in this edit? WiiAlbanyGirl (talk) 13:03, 4 July 2009 (UTC)

Reference to broken DOI

A reference was recently added to this article using the Cite DOI template. The citation bot tried to expand the citation, but could not access the specified DOI. Please check that the DOI doi:10.1016/j.fertnstert.2009.02.057 has been correctly entered. If the DOI is correct, it is possible that it has not yet been entered into the CrossRef database. Please complete the reference by hand here. The script that left this message was unable to track down the user who added the citation; it may be prudent to alert them to this message. Thanks, Citation bot 2 (talk) 12:25, 12 August 2010 (UTC)

Symptoms

This is from my own personal experiences which lasted over 30 years during which time I visited various gynecologists seeking help. My symptoms also included loss of conscienceness (fainting)and vomiting. My periods lasted anywhere between 7-10 days with heavy flow during the first 5 days. Blood flow included blood clots. The pain during these periods were excruciating & disabling. After a total hysterectomy, with the exception of the vomiting & fainting, the other symptoms remain in less intensity compared to when I menstruated.76.255.181.56 (talk) 17:21, 14 September 2010 (UTC)

Smoking

I apologize - this is my first time raising an issue so please bear with me.

The section on smoking begins with "Smokers tend to be at a lower risk for endometriosis. Despite the previous statement, several case studies have been presented by Dr. Megna showing that many times smokers not only have Endometriosis but they also show more severe symptoms."

It isn't clear to me why the editor left a contradiction - smoking can increase the risk, or it can't, or the research is inconclusive. So I feel the sections fails to meet standards for clarity. But the bulk of the section's info lacks citations. Who is this Dr Megna? A quick google search gives only two results - this article and an entry on answers.com that is copied from here.

The editor who introduced Dr Megna's work should find or bring the citations necessary and rewrite the section so it's clear if smoking increases the risk or not. AberFree (talk) 13:55, 2 April 2011 (UTC)AberFree

Disadvantages of surgery section needed

This section is missing - there is an advantage and disadvantage for medicinal treatments, but only an advantages of surgery section. There needs to be a surgery disadvantages section for balance, I'm not familiar enough with the condition to add it in. Dallas (talk) 02:24, 24 June 2011 (UTC)

Medication: Research

My contribution mentioning research results (Fertility and Sterility journal) on the effects of EGCG (a green tea extract) were considered good faith edits and removed. Admittedly it is misleading to place this directly in a medication section since the findings referred to did not undergo any clinical trials.

I would like to suggest to add a general research section, or a research subsection to the medication section, where such things could be covered.

Any comments welcome. Best regards --Biomeddude (talk) —Preceding undated comment added 13:54, 5 September 2011 (UTC).

There are potentially dozens/hundreds of drugs that are being examined as possible endometriosis treatment drugs that have not undergone clinical trials. Most of them might never undergo clinical trials or be approved for treatment in humans. So it seems like lots of speculation. I am hesitant to support a section where drugs that have somehow shown a benefit in treating transplanted endometrium in animals. I could see the lay person being misled, and self-medicate, and get worse. — Preceding unsigned comment added by Absolutezero273 (talk • contribs) 16:52, 15 December 2011 (UTC)