Women's Health Services

NewYork-Presbyterian Women's Health Services

Endometriosis

Endometriosis is a common and chronic condition that can impact a woman’s health, fertility, and quality of life. At NewYork-Presbyterian, multidisciplinary teams of specialty physicians provide women with endometriosis a comprehensive and individualized plan of care that addresses their unique needs. Our goal is to accurately and efficiently diagnose endometriosis and use the least invasive treatment possible to manage each woman’s symptoms, goals, and reproductive plans. Through NewYork-Presbyterian’s extensive network of resources and support services, we help women navigate the complex issues surrounding endometriosis throughout their reproductive years.

Endometriosis

What is endometriosis?

Endometriosis is a condition in which tissue that lines the uterus is found outside of the uterus, usually on the ovaries, fallopian tubes, and other pelvic structures. The tissue can also grow around other organs, including the bladder, bowel, diaphragm, and lungs. When endometrial tissue implants on these structures outside the uterus, it can cause pain and inflammation.

Women with endometriosis can experience a diversity of symptoms, many of which are vague and can overlap with other conditions. These symptoms include:

  • Painful menstrual periods
  • Chronic pelvic pain
  • Painful intercourse
  • Infertility
  • Irregular bleeding
  • Fatigue
  • Digestive problems, including diarrhea, constipation, bloating, or nausea
  • Painful bladder symptoms

Endometriosis is a leading cause of infertility. The tissue can cover or grow into the ovaries or block fallopian tubes. Trapped blood in the ovaries can form cysts. The tissue can also form scar tissue and adhesions (a type of tissue that can bind your organs together). This scar tissue may cause pelvic pain and make it difficult for a woman to get pregnant.

Some women attribute their endometrial pain to normal menstrual discomfort. It may take years for someone to consider endometriosis as a possible cause of their pain. This delay may lead to a missed opportunity to address a condition that could impair fertility and quality of life.

Our Approach to Care

Multidisciplinary & Comprehensive Programs to Treat Endometriosis

The complex nature of endometriosis requires a comprehensive and interdisciplinary treatment approach to address each woman’s specific needs. At NewYork-Presbyterian/Columbia University Irving Medical Center and NewYork-Presbyterian/Weill Cornell Medical Center, expert physicians and surgeons in gynecology collaborate to formulate an individualized care plan tailored to a woman’s unique condition, symptoms, and reproductive goals. Depending on the location and severity of the endometriosis, the team may also collaborate with reproductive endocrinologists, colorectal specialists, urologists, or thoracic (lung) surgeons. Pain management physicians and physical therapists are also often involved in management plans. Treatments may include lifestyle modifications such as diet and exercise, medications, or the latest cutting-edge, minimally invasive approaches to surgery that result in smaller scars, fewer complications, faster recovery times, and fertility preservation. NewYork-Presbyterian also offers integrative health services, including yoga, acupuncture, and meditation. Patients can speak to their health care provider to learn more about integrative health services.

Advancing the field through research

Columbia and Weill Cornell Medicine clinician-investigators remain at the forefront of research related to endometriosis. Our clinician-investigators continue to pursue studies of new therapies. Our patients benefit from treatments and therapies based on the most up-to-date research and findings.

Doctor with a patient

Diagnosis & treatment

Early diagnosis and treatment can significantly help improve symptoms and reduce health and fertility problems for women with endometriosis. Although no medical cure exists for endometriosis, medications and surgery can help lessen its severity, often providing long, if not indefinite, periods of relief.

Diagnosis

Our compassionate physicians listen to patients’ concerns and learn about their symptoms. If endometriosis is suspected based on a patient’s symptoms and pelvic exam, imaging such as an ultrasound or MRI may be helpful, especially in cases where the ovary is involved, or there are larger endometrial implants. However, the only way to confirm a diagnosis of endometriosis is through a surgical procedure called a laparoscopy. Sometimes, a small amount of tissue is removed during the procedure, called a biopsy, that a pathologist reviews to confirm the diagnosis.

Treatments

At NewYork-Presbyterian, treatment for endometriosis is individualized and depends on considerations such as the severity of the symptoms, the extent of the disease, and the reproductive desires of the patient. Treatment options may include medical therapies, surgical treatments, and lifestyle recommendations for diet and exercise.

Medical therapies

If you have endometriosis and have mild symptoms, your doctor may suggest taking medications:

  • Over-the-counter drugs such as ibuprofen or acetaminophen can be used for mild pain or cramps.
  • Birth control pills
  • Progesterone pills, injection, or intrauterine device (IUD)
  • GnRH agonists (Lupron)
  • GnRH antagonist (Elagolix)
Surgical treatments

Surgery may be recommended for women whose endometriosis does not respond to medication or those who want a definitive diagnosis of endometriosis. Surgery may also be recommended for deep infiltrative disease with larger endometriotic implants and involvement of surrounding organs such as the bowel and bladder.

Types of surgery include:

  • Diagnostic laparoscopy with biopsies
  • Laparoscopic or robotic excision of endometriotic implants or deep infiltrating disease
  • Excision of abdominal wall endometriosis
  • Laparoscopic or robotic ovarian cystectomy
  • Laparoscopic or robotic hysterectomy (removal of the uterus)
  • Open surgery (when a minimally invasive approach is not recommended)

At NewYork-Presbyterian, our experienced gynecologic surgeons collaborate with our highly skilled staff to provide the highest level of care before, during, and after surgery.

Long-term management

Our team is committed to giving patients with endometriosis comprehensive, ongoing care that will enable them to live the best quality of life. Depending on your individual needs, your long-term care may include periodic evaluations to review your symptoms and monitor your endometriosis with abdominal and pelvic examinations. Endometriosis often improves after menopause, when there is a decline in the production of reproductive hormones. However, because the body still produces small amounts of estrogen, some women will continue to have symptoms after menopause. Our compassionate specialists address each woman’s changing needs throughout her lifespan.

Why Choose Us

Specialists in the Treatment of Deep Infiltrative Endometriosis

Deep infiltrative endometriosis involves organs in the abdomen and pelvis. Our gynecology specialists collaborate with reproductive endocrinologists, colorectal specialists, and urologists to address and manage endometriosis patients who desire fertility-sparing surgery and those who have extensive endometriosis involving organs such as the bowel, the bladder, and the ureter.

Experts in minimally invasive gynecologic surgery

Minimally invasive gynecologic surgery (MIGS) such as laparoscopy and robotic-assisted surgery offers huge benefits diagnosing and treating endometriosis and when fertility preservation is a priority. Compared to “open” surgery, MIGS provides surgeons with superior magnification and enhanced visibility, which results in a more accurate diagnosis and an opportunity for more thorough excisional treatment. Benefits of these less invasive approaches include faster recovery, less pain, less scarring, fewer complications, and shorter hospital stays.

Our expert gynecologic surgeons are renowned for their skill in laparoscopy and robotic-assisted surgery to treat the most complex and challenging gynecologic conditions. As leaders and innovators in the field, they work collaboratively to develop and refine minimally invasive techniques that ease recovery for patients with fewer complications. These include the ever-growing application of the use of robotics in fertility-sparing and fertility-enhancing surgery to treat endometriosis.

Contact Us


Obstetrics & Gynecology

Iris Cantor Women’s Health Center

Obstetrics & Gynecology

NewYork-Presbyterian/Columbia University Irving Medical Center

855-969-7564 For new patients

212-305-5904 For existing patients

Obstetrics & Gynecology

Obstetrics & Gynecology

NewYork-Presbyterian Queens

Obstetrics & Gynecology

NewYork-Presbyterian Brooklyn Methodist Hospital

ColumbiaDoctors — Westchester