Eylül GÜN, MD
Dr. Gun is a Turkish histopathologist who currently works in the United Kingdom. She is a member of some national societies as well as international ones such as the European Society of Pathology and the Royal College of Pathologists, UK. She is interested in gynecological and urological pathology and has been doing research on these subjects.
Revolutionizing endometriosis diagnosis: Advances in radiological imaging
With recent advances in diagnostic radiological imaging, the diagnosis of endometriosis, particularly for deep and ovarian endometriosis, has been revolutionized. Updated guidelines now recommend the initial use of endometriosis transvaginal ultrasound (eTVUS) and magnetic resonance imaging (eMRI) for diagnosis, although surgery and histology are still necessary for confirmation and treatment. Avery et al., together with the Imagendo Study Group from Australia, Canada, and the UK conducted a review of recent literature focusing on the diagnostic value of eTVUS, its combinations…
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Quercetin and its effects on endometriosis
Endometriosis, as a disease characterized by chronic inflammation and fibrosis, could be a potential target for quercetin, a flavonoid found in various foods and botanicals, and a known senolytic agent with many effects including antioxidant, anti-inflammatory, and immune-modulatory properties. Studies suggest its potential efficacy in animal models and pain reduction in endometriosis patients. Delenko et al. from New York, under the leadership of Dr. Gregersen and Dr Metz from Feinstein Institutes for Medical Research-Northwell Health, USA investigated the menstrual-effluent derived…
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Current status of non-invasive biomarkers for endometriosis
Laparoscopy has been the gold standard for the diagnosis of endometriosis, however, the understanding of how many people have the condition is limited because not everyone undergoes surgery. The different treatment modalities for patients with unexplained infertility and the invasiveness of the surgical approach prompted a need for non-invasive diagnostic methods. Komorowski and Feinberg from Chicago, Illinois gave an overview of the present state of non-invasive biomarkers in the February 2024 issue of the journal Fertility and Sterility’s Views and…
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Exploring the role of thyroid function in endometriosis and polycystic ovary syndrome
Endometriosis, polycystic ovary syndrome (PCOS), and thyroid disorders are prevalent among women of reproductive age, yet their exact impacts on reproductive health and underlying mechanisms remain unclear. Given the close association of these conditions through the endocrine system, Kirkegaard et al. from Aalborg, Denmark aimed to explore existing literature to investigate the potential associations between thyroid dysfunction/autoimmunity and gynecological disorders alongside an evaluation of associations in a Danish cohort of early pregnant women. The authors hypothesized that the contrasting biochemical…
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Understanding endometriosis pain
Chronic pain, especially in conditions like endometriosis, poses significant challenges for diagnosis and treatment due to its multifaceted nature. Elina Helosvuori and Venla Oikkonen from Finland conducted a study in which they aimed to explore the complexities of chronic pain, particularly in the context of endometriosis, by analyzing how individuals with this condition develop embodied knowledge of their pain. They tried to understand how pain sensations are interpreted and communicated, shedding light on the discrepancies between patient experiences and medical…
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Endometriosis treatment at diagnosis: Is it possible?
For most cases of endometriosis, a diagnostic laparoscopy followed by a therapeutic laparoscopy is recommended by The National Institute for Health and Care Excellence. Hypothesizing that patients with endometriosis might benefit from receiving only a therapeutic laparoscopy, combining diagnosis and treatment in one procedure, potentially avoiding the need for separate diagnostic interventions, Lloyd-Davies et al. from Cambridge, United Kingdom conducted a retrospective cohort study. The study was published in the November 2023 issue of the Clinical Medicine Journal (ClinMed London). …
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Risk of endometriosis and related occupational factors among working women
As a debilitating disease, endometriosis is well known to have effects on the patient's overall quality of life. Various studies have consistently reported that working women face an increased risk of endometriosis growth. Lee et al. from Korea conducted a study to explore factors associated with endometriosis and estimate their risks in the Korean working population. The study was published in the October 2023 issue of the journal PLoS One The authors used the 2007–2015 National Health Insurance Service–Female Employees database…
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Why is there a higher risk of stroke for women with endometriosis?
Women diagnosed with endometriosis might face an increased susceptibility to stroke due to alterations in the levels of some molecules in their systems. Studies indicate that especially those undergoing hysterectomy/oophorectomy, have an approximately 30% higher risk of stroke. Dr. Mormile from Italy wrote an editorial hypothesizing that certain biomolecules may be playing a part in increasing the susceptibility to stroke in women with endometriosis. It was published in the January 2024 issue of the journal European Journal of Obstetrics &…
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Coupled torture due to endometriosis and depressive symptoms
Endometriosis significantly impacts various aspects of women's lives including their physical and mental health, careers, and social relationships. Physically, it causes chronic pelvic pain and dyspareunia, affecting 5-10% of reproductive-age women and leading to infertility challenges and a substantial percentage of affected women experience impaired mental health. Career-wise, it decreases academic and job performance, causing an average loss of one working day. It also affects the social life of the patients by straining relationships and causing progressive isolation, particularly after…
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The urgent need for research and compassionate care in endometriosis
Endometriosis, a common yet little-known inflammatory disorder, has significant patient and public health impacts due to underinvestment in its research and care. Delayed diagnosis and inadequate care persist due to reliance on surgical methods and limited advancements in medical therapies. Menstrual stigma, gender biases, and racial disparities further hinder access to quality care globally. Lack of awareness and discomfort surrounding menstrual health among healthcare providers exacerbate these challenges. Guidice et al. from the US and the UK called for action…
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Neurotrophins proposed as possible biomarkers for endometriosis
As the search for a good-quality biomarker in endometriosis continues, certain growth factors have been investigated for their roles in the pathophysiology of the disease. Neurotrophins, as regulators of neuronal development and survival, are also known to take part in peripheral pain pathways as well as central sensitization. Taking into account that the brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) have been shown to be affected by hormone levels, Liu et al. from Zhejiang, China conducted a meta-analysis…
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New developments in endometriosis from a molecular and cellular standpoint
Researchers are making significant progress in endometriosis regarding molecular and cellular research, with collaborative efforts by clinicians, scientists, surgeons, and biostatisticians. Laganà et al. from Italy wrote an editorial regarding the recent special issue called "Molecular and Cellular Advances in Endometriosis Research 2.0" which was published in the August 2023 issue of the International Journal of Molecular Sciences showcasing noteworthy articles that highlight progress in understanding and addressing endometriosis. The authors mentioned the different molecular pathways discovered when comparing the eutopic and ectopic…
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A synopsis of deep infiltrating endometriosis of the digestive system
The gastrointestinal tract is one of the most common locations of extrapelvic endometriosis. Its infiltrative counterpart exhibits more aggressive behavior and often needs to be distinguished from malignancies clinically. Yin et al. from Harbin, China reviewed the latest findings regarding the underlying pathogenetic and molecular mechanisms of the digestive system infiltrating endometriosis (DSIE). The article was published in the August 2023 issue of the Journal of Cellular and Molecular Medicine. The most common site for digestive system infiltrating endometriosis is known…
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Blood-based biomarkers for the detection of endometriosis and adenomyosis
One of the biggest challenges in endometriosis management is the delay in diagnosis. Scientists have been trying to come up with biomarkers to detect it quicker. Thinking blood-based biomarkers could aid in earlier diagnosis and help with the duly administration of patient management procedures, researchers from various European countries led by Burghaus et al. conducted a multicenter prospective study with the aim of finding a highly sensitive biomarker to detect suspected endometriosis/adenomyosis. The study was published in the August 2023…
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The Importance of "uterine adenogenesis" in endometriosis development
Understanding the complex pathogenetic mechanisms underlying endometriosis has been a big challenge. Several studies have demonstrated that the eutopic and ectopic endometrium exhibit distinct characteristics. Researchers led by Signorile et al. from Italy conducted a review of the recent developments in endometriosis pathobiology, touching on "endometrial adenogenesis" in particular. The article was published in the journal named In Vivo. Upon a thorough literature search, approximately 100 articles were analyzed. The epidemiology, risk factors for endometriosis, and recent advances in diagnosis, imagining,…
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The overlap of endometriosis and polycystic ovarian syndrome
Polycystic ovarian syndrome (PCOS) is one of the most common causes of female subfertility similar to endometriosis. It has been hypothesized that owing to the underlying pathophysiological mechanisms, women with endometriosis are at a greater risk of having PCOS than healthy women. However, the true incidence of this overlap has only been evaluated in small clinical groups. Schliep et al. from the USA carried out a study using an operative cohort of patients from a previous endometriosis study (the Endometriosis,…
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A suggestion for a novel in vitro diagnostic test for endometriosis
As the research continues to find a gold standard non-invasive diagnostic method for endometriosis, there still is no definitive answer. One of the most commonly studied markers is Cancer Antigen 125 (CA125) – a biomarker that is secreted from the derivatives of the embryonic coelomic epithelium which is shown to be significantly increased in the later stages of endometriosis in previous studies. Another is brain-derived neurotrophic factor (BDNF) – a neurotrophin that is shown to be increased in the ectopic…
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Menstruating eye: Very rare but possible
Extragenital cyclical bleeding during a menstrual cycle is called vicarious menstruation and it is mostly reported to be seen in the nasal mucosa but can involve any other organ such as the lungs, stomach, kidney, etc. Endometriosis is a common cause of vicarious menstruation in which endometriotic tissue reaches extragenital places either via the hematogenous or lymphatic spread. The eye is one of the rarest sites of extra-pelvic endometriosis. In their review, Rahman et al. from the US and Lebanon intended…
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The relationship between lipids and estrogen in endometriosis
Lipid metabolism plays important roles in many physiological and pathological conditions such as the storage of energy, immune system functions, steroid hormone production, inflammation, and chronic diseases such as diabetes mellitus and hyperlipidemia. In an attempt to figure out the relationships between lipid profiles, estrogen levels, body mass index (BMI), and endometriosis, Zheng et al. from China conducted a retrospective study which was published in the July 2023 issue of the journal Medicine (Baltimore). Patients who were operated on for…
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Peritoneal Endometriosis and Acyclical pelvic pain
The most debilitating symptom of endometriosis is chronic pelvic pain. The peripheral nervous system is affected and the growth and regeneration of sensory nerve fibers in endometriotic tissue has been identified. The first line treatment which is hormonal therapy for endometriosis is found to be effective in reducing the cyclical pelvic pain also known as nociceptive pain, however, it may exaggerate the acyclical pelvic pain which is related to neurogenic inflammation and peripheral sensitization. Voltolini Velho et al. from Berlin,…
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