DEBUNKING THE MYTHS ABOUT ENDOMETRIOSIS

                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, April 6, 1993                   TAG: 9304060158
SECTION: EXTRA                    PAGE: 6   EDITION: METRO 
SOURCE: LYLE BREITKOPF ASSOCIATED PRESS
DATELINE:                                 LENGTH: Medium
DEBUNKING THE MYTHS ABOUT ENDOMETRIOSIS
For millions of American women, the chronic progressive pain of endometriosis is known all too well even though the exact cause of the disease remains uncertain.
More than 10 million women in the United States suffer from the Second of two parts disease, and thousands of cases go unrecognized, undiagnosed and untreated.
The painful condition is caused by menstrual tissue found outside the uterus, usually as adhesions or cysts. The tissue responds to the monthly cycle of hormones leading to a monthly recurrence of pain.
There have been encouraging advances in treatment, and the first step in the healing process is educating people and dispelling some of the myths about the disease - as in the following:
Myth: Endometriosis is a "Career Woman's" disease.
Endometriosis can affect any woman in her childbearing years, and it is not uncommon for the disease to strike young women experiencing their earliest menstrual periods.
Myth: Pregnancy cures the disease.
Because the tissues responsible for pain respond to estrogen levels, the lesions shrink and the pain often subsides during pregnancy. In fact, the lesions are dramatically reduced in size during pregnancy. When regular estrogen levels return after pregnancy, however, so do the lesions.
Myth: The disease can be evaluated by the severity of the pain.
This just may be the single most dangerous misunderstanding of all. Endometriosis is a very strange disease. One patient with a small amount of endometriosis may be in great pain, and another with a large amount may not feel anything. A complete exam is the only sure way for any woman to protect her health and her ability to plan for children.
Myth: Medication is effective if the pain is under control.
Medication is available in many forms, each with its own side effects. Some induce a false pregnancy, others mimic male hormones and some are anti-inflammatory drugs. But side effects can range from hot flashes to liver damage to elevated cholesterol levels.
Myth: Though painful, the disease isn't a big fertility risk.
Whether through scarring, causing a hostile environment for sperm or mechanisms as yet not understood, endometriosis is a leading cause of infertility (defined as no pregnancy after a year of monitored attempts). Anywhere from 20 percent to 40 percent of women with infertility turn out to have endometriosis.
Myth: A regular exam can determine the extent of the disease.
The only sure way to check for the disease is by laparoscopy, a careful visual inspection of the abdominal cavity. The physician uses a small optical instrument to check for lesions in an office surgical procedure. It is a "gold standard" of diagnosis because it allows physicians to see areas they can't examine any other way.
Stripped of all the myths and misunderstandings, endometriosis can be treated and managed successfully by patient and physician. For while new treatments continue to be researched and developed, a woman's most effective means of protection are still knowledge and awareness - and detection of the disease in its early stages.

Dr. Lyle Breitkopf is a clinical professor of obstetrics and gynecology at New York University Medical Center.

by Bhavesh Jinadra by CNB