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Endometriosis evolves from teenage years into adulthood, often progressing from manageable period pain to symptoms outside the menstrual cycle that no longer respond to hormonal treatments. Dr. Megan Wasson, Chair of Medical and Surgical Gynecology at Mayo Clinic Arizona, breaks down this journey and provides clarity on when to consider moving beyond conservative management.
• Endometriosis commonly progresses in both disease burden and symptom severity over time
• Common misdiagnoses include IBS, anxiety, “lack of sexual experience,” primary dysmenorrhea, and orthopedic issues
• Decision for surgery should be individualized based on quality of life considerations
• Surgery may be appropriate when diagnostic uncertainty causes anxiety
• Surgical treatment can be beneficial when symptoms aren’t controlled by hormonal treatments
• Removing endometriosis can optimize fertility for both natural conception and assisted reproductive technologies
• Complementary approaches like pelvic floor physical therapy and acupuncture can support conventional treatments
Send your questions to contact@endobattery.com or visit endobattery.com/contact, and we’ll bring you expert answers in our next Quick Connect episode.
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Endo's Evolution Through Life Stages
Speaker 1
0:00
How
does
endometriosis
change
as
we
move
from
teenage
years
into
adulthood
?
Why
do
so
many
patients
get
told
it's
just
IBS
,
anxiety
or
even
a
lack
of
experience
?
In
this
episode
of
EndoBattery
Quick
Connect
,
dr
Megan
Wasson
breaks
down
the
evolution
of
endosymptoms
,
the
most
common
misdiagnoses
and
when
it's
time
to
consider
surgery
versus
sticking
with
conservative
treatments
.
Whether
you're
newly
diagnosed
or
have
been
battling
endo
for
years
,
this
conversation
will
give
you
clarity
,
validation
and
practical
next
steps
.
Stay
tuned
.
This
is
one
you
don't
want
to
miss
.
Speaker 2
0:37
Life
moves
fast
and
so
should
the
answers
to
your
biggest
questions
.
Welcome
to
EndoBattery's
Quick
Connect
,
your
direct
line
to
expert
insights
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,
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.
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send
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,
I
bring
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the
experts
and
in
just
five
minutes
you
get
the
knowledge
you
need
.
No
long
episodes
,
no
extra
time
needed
,
and
just
remember
expert
opinions
shared
here
are
for
general
information
and
not
for
personalized
medical
advice
.
Always
consult
your
provider
for
your
case-specific
guidance
.
Got
a
question
?
Send
it
in
and
let's
quickly
get
you
the
answers
.
I'm
your
host
,
alana
,
and
it's
Common Misdiagnoses Explained
Speaker 2
1:14
time
to
connect
.
Speaker 2
1:17
Today's
guest
,
dr
Megan
Wasson
,
is
the
chair
of
the
Department
of
Medical
and
Surgical
Gynecology
at
the
Mayo
Clinic
in
Arizona
and
a
professor
of
obstetricsurgical
Gynecology
at
the
Mayo
Clinic
in
Arizona
and
a
professor
of
obstetrics
and
gynecology
at
the
Mayo
Clinic
of
Medicine
and
Science
.
She's
a
leader
in
minimally
invasive
gynecologic
surgery
and
a
respected
educator
,
named
Outstanding
Emerging
Educator
of
2020
.
And
she's
an
internationally
recognized
speaker
,
with
over
200
invited
lectures
and
more
than
70
peer-reviewed
publications
.
Her
clinical
focus
includes
endometriosis
,
chronic
pelvic
pain
and
advanced
surgical
techniques
.
Whether
it's
in
the
operating
room
,
at
the
podium
or
shaping
global
surgical
standards
,
dr
Megan
Wasson
is
helping
redefine
what
care
can
look
like
for
patients
around
the
world
.
Let's
get
into
this
.
How
does
endo
tend
to
evolve
from
adolescence
into
adulthood
?
Speaker 3
2:08
Yeah
,
we
know
that
endometriosis
is
a
progressive
condition
,
so
it's
not
uncommon
for
not
only
the
disease
to
grow
.
If
we're
doing
like
imaging
,
watching
things
on
ultrasound
MRI
,
it's
not
uncommon
for
there
to
be
that
progression
and
disease
burden
.
But
it's
also
not
uncommon
to
see
progression
and
symptoms
.
That
initially
,
yeah
,
I
had
painful
cycles
.
I
was
starting
on
birth
control
pills
as
a
13
year
old
which
,
again
,
I
don't
necessarily
disagree
with
.
I
think
that's
fine
as
a
first
step
and
,
yep
,
it
worked
.
I
put
a
bandaid
on
it
.
But
now
I'm
18
,
19
,
20
,
and
now
I'm
starting
to
have
pain
outside
of
my
cycle
or
the
pain
is
no
longer
controlled
with
the
birth
control
pills
.
That
we're
starting
to
see
more
and
more
symptoms
.
That's
a
very
classic
presentation
of
endometriosis
.
Speaker 2
2:56
Yeah
.
What
are
the
common
misdiagnoses
during
When to Consider Surgery
Speaker 2
3:00
this
time
?
Speaker 3
3:01
Yeah
,
so
irritable
bowel
syndrome
is
a
very
,
very
common
one
.
That
,
yes
,
you
can
have
some
diarrhea
,
constipation
and
that's
just
anxiety
as
well
,
is
a
very
common
misdiagnosis
.
Lack
of
sexual
experience
is
something
that
I
very
commonly
hear
as
well
,
that
people
are
having
difficulty
with
intercourse
just
because
they're
new
in
their
sexual
journey
and
so
it'll
just
take
a
little
bit
of
time
.
Primary
dysmenorrhea
is
another
very
common
word
thrown
out
,
and
diagnosis
thrown
out
,
that
it's
because
of
the
prostaglandins
that
the
uterus
releases
and
that's
where
the
pain
is
coming
from
.
Also
labral
tears
,
so
orthopedic
injuries
can
be
the
source
.
Truly
,
everyone
wants
to
think
about
things
outside
of
GYN
.
Speaker 2
3:50
When
we're
starting
to
think
about
progressive
symptoms
as
well
,
when
should
someone
push
for
surgical
consultation
versus
going
on
the
conservative
management
route
?
Speaker 3
4:00
Yeah
,
yeah
,
that's
a
really
great
question
and
it's
not
a
one
size
fits
all
.
I
always
step
back
and
remind
myself
,
as
well
as
the
individuals
that
I'm
caring
for
.
This
is
a
quality
of
life
issue
.
So
just
because
a
treatment
option
is
a
good
option
for
one
person
doesn't
mean
it's
best
for
another
person
and
it
really
needs
to
be
individualized
to
you
,
focused
on
your
priorities
,
your
goals
,
your
expectations
.
Your
priorities
,
your
goals
,
your
expectations
.
Speaker 3
4:25
So
,
in
terms
of
when
someone
should
consider
surgery
,
lots
of
different
reasons
.
Number
one
,
if
it's
something
that's
always
been
in
the
back
of
your
mind
and
constantly
been
this
well
,
do
I
have
it
,
do
I
not
have
it
?
And
it
keeps
you
up
at
night
and
is
causing
a
lot
of
anxiety
,
a
lot
of
stress
For
some
individuals
.
Just
having
that
definitive
yes
or
no
is
this
or
is
this
not
endometriosis
gives
so
much
peace
of
mind
and
so
much
peace
in
general
that
it's
incredibly
helpful
.
So
that's
where
I
am
never
opposed
to
just
giving
someone
that
definitive
answer
.
But
when
we
talk
about
the
other
quality
of
life
issues
,
so
those
symptoms
,
if
someone
is
having
symptoms
that
are
not
being
controlled
with
those
band-aids
,
the
birth
control
pills
,
iuds
,
progesterone-only
pills
then
that's
where
there
should
be
a
very
thoughtful
conversation
about
is
it
time
to
do
something
different
,
and
that
may
include
surgery
versus
pelvic
floor
,
physical
therapy
,
acupuncture
there's
a
lot
of
adjuncts
that
we
can
use
to
help
support
the
body
as
it
processes
and
copes
with
endometriosis
.
To
help
support
the
body
as
it
processes
and
copes
with
endometriosis
.
Speaker 3
5:30
Additionally
,
if
someone
is
wanting
to
pursue
pregnancy
and
cannot
be
on
those
Band-Aid
medications
because
,
let's
be
honest
,
being
on
birth
control
pills
when
you're
trying
to
get
pregnant
,
that
is
not
conducive
.
So
if
you
can't
be
on
your
Band-Aid
and
being
off
the
Band-Aid
is
not
conducive
either
,
can't
be
on
your
band-aid
and
being
off
the
band-aid
is
not
Fertility and Endometriosis
Speaker 3
5:49
conducive
either
.
Yeah
,
Doing
a
surgery
may
absolutely
be
justified
at
that
precise
moment
in
time
,
with
the
secondary
benefit
of
not
only
can
we
surgically
help
to
decrease
those
symptoms
,
but
we
can
also
help
optimize
,
whether
that's
for
natural
pregnancy
,
which
there
is
good
evidence
to
show
that
removing
endometriosis
can
help
optimize
for
natural
fertility
,
being
able
to
get
pregnant
without
any
intervention
,
as
well
as
helping
to
optimize
for
artificial
reproductive
technology
.
So
,
individuals
who
do
need
things
like
intrauterine
insemination
,
in
vitro
fertilization
,
excising
endometriosis
,
getting
rid
of
that
inflammation
,
can
help
to
optimize
for
that
as
well
.
Episode Wrap-Up
Speaker 2
6:26
That's
a
wrap
for
this
Quick
Connect
.
I
hope
today's
insights
helped
you
move
forward
with
more
clarity
and
confidence
.
Do
you
have
more
questions
?
Keep
them
coming
.
Send
them
in
and
I'll
bring
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the
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answers
.
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can
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using
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link
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episode
or
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endobatterycom
or
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endobatterycom
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.
Until
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,
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.