Eylül GÜN, MD

Dr Gun is a histopathologist who graduated from Aydin Adnan Menderes University and completed her surgical pathology training in Izmir Katip Celebi University Ataturk Training and Research Hospital in Turkey. She has presented her studies as a bursary awardee many times in the international congresses of the European Society of Pathology. She is a Diplomate of the Royal College of Pathologists, UK. She is interested in gynecological and urological pathology and has been doing research on these subjects. 

Vitamin C as a possible therapeutic agent in endometriosis

A rather toxic environment is generated with the production of reactive oxygen species by the immune cells in endometriosis. The anti-oxidant metabolism is also altered which results in a state of oxidative stress. As a potent antioxidant, Vitamin C has many effective properties such as anti-inflammatory, anti-angiogenic, and immune stimulator and thus, it is thought to prevent the development of endometriotic lesions. With the increasing need for novel therapeutic agents, many studies have been focusing on non-hormonal methods in endometriosis…

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Fibrosis is not only a histological finding in endometriosis

Endometriosis remains to be an active subject of research with its complex pathophysiology and the indistinct mechanisms that cause the proliferation and progression of the lesions. Besides the already known characteristics of the disease, there is strong evidence to support fibrosis as a molecular hallmark of the disease, and Dr. Burney from Washington, USA has shared his reflections on the importance of fibrosis in endometriosis. The article was published in the July 2022 issue of the journal Fertility and Sterility.…

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An important matter to revise: Immune system changes in endometriosis

Endometriosis is a multifactorial disease with unclear and obscure pathogenetic mechanisms. In their review, Chopyak et al. revised the immunopathogenic pathways that are proven and/or thought to be responsible for disease development and progression. The article was published in the March 2022 issue of the Central European Journal of Immunology. Alterations in the functions of the immune cells play an important role in endometriosis pathogenesis. Systemic and local changes are observed in both innate and humoral immune cell levels which…

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The effects of resveratrol on endometriotic cells

The current treatment methods for endometriosis still carry recurrence risks and side effects from medications. Herbal medicine has been investigated and used as an additional alternative method. Derived from several plants and found in some dietary sources, resveratrol is a natural polyphenol. It has many features such as anti-carcinogenic, anti-inflammatory, antioxidant, and pro-apoptotic. The exact molecular mechanism however is yet to be known. Its role in inhibiting angiogenesis has also been a subject of cancer research and its use in…

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The best method for the diagnosis of endometriosis: SEE and BELIEVE

Deciding on the best diagnostic procedure for endometriosis patients has been a recent subject of debate. While some clinicians believe non-invasive methods such as imaging and symptom-based treatment should be the choice in the diagnosis, some believe the best method to detect the lesion is by seeing it via diagnostic laparoscopy. In the debate article written by Mak et al., it is argued that diagnostic laparoscopy is still a justified and useful diagnostic test in the diagnosis of endometriosis. The…

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Time has come to learn more about endometriosis and take action!

It has been a long time since endometriosis was defined. Extensive population studies have shown that around 10% of women suffer from this condition. Depending on its severity, it alters the various functions of the body and causes the patients to suffer. A perspective article by Ellis et al. attracts attention to the current knowledge and actions on endometriosis and was published in the May 2022 issue of the journal Frontiers in Global Women’s Health. The authors first detail the…

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Is it possible to reduce pain by diet in endometriosis?

Endometriosis-related pain is one of the most common symptoms of endometriosis that significantly affects the patient's quality of life. The peripheral and central sensitization, caused by chronic inflammation activation, may result in referred pain. The pain perception was shown to be decreased with dietary changes by some studies, including in patients with endometriosis. These changes include intake of Omega-3 polyunsaturated fatty acids (PUFAs), a low FODMAP diet, a Mediterranean diet, a gluten-free diet, and a low nickel diet. Researchers from…

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A new potential therapeutic target in endometriosis: Galectin-3

The endometrial cells migrate and attach to the peritoneal surface according to the most widely accepted retrograde menstruation theory in endometriosis development. Given that only 10% of women have endometriosis, it is thought that some additional factors contribute to the disease progression, such as inflammatory environment and immune status.  The eutopic endometrium’s cell surface molecules have been investigated with the hypothesis that the eutopic endometrium’s molecular structure makes way for endometriosis development. Galectin-3, a cell surface molecule of the lectin…

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How do regional differences affect the incidence rates of endometriosis?

Despite all the ongoing work for endometriosis awareness, it continues to be an underdiagnosed disease. Several different factors are responsible for this. The variations of its symptomatology play a big part as well as the lack of understanding of the symptoms by the clinicians. Another thing that contributes to this is the insufficiency in describing the abnormal pain felt by the patients. Public health and patient organizations have been developed in many areas, however, geographical, cultural, and socioeconomic factors seem…

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Understanding the expression of endometriosis-related pain: A barrier to overcome

It is difficult to describe the feeling of pain, one of the most important symptoms of endometriosis because it is subjective. Endometriosis-related pain is proven to be underestimated by some clinicians resulting in the patient getting a late diagnosis. It has a significant impact on the quality of life of the patients. Women try to express their pain in different ways and it is crucial for clinicians to recognize this pain and act on it. There is little data about the…

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Endometriosis in transmasculine people

“Transmasculine” refers to people who were assigned female at birth but later identify themselves with masculinity. If they choose to transition to the male gender, they are then prescribed long-term testosterone and some may want to undergo a hysterectomy as a gender-affirming surgery. Very little is known about the incidence of pelvic pain and its causes in transmasculine people, and in their commentary, Dr. Ferrando from Cleveland, Ohio, USA aimed to take a look at the literature regarding pelvic pain…

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Is it possible to predict recurrence after ovarian endometriosis surgery?

The current treatment methods for endometriosis both have their flaws: the medical treatment is sometimes ineffective and the surgical treatment comes with a high rate of recurrence. Even though new surgical modalities have been developed, laparoscopic cyst removal continues to be the first choice in many cases.  Huang et. al performed a study in which they retrospectively analyzed the clinical and follow-up data of ovarian endometriosis patients who underwent laparoscopic cyst debulking surgery with the aim to scrutinize the factors…

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Does inhibiting the formation of the new blood vessels aid in endometriosis treatment?

Current treatment modalities for endometriosis include a hormonal alteration which has many side effects and surgical removal which has a high postoperative recurrence rate. Alternative non-hormonal treatment methods have been investigated and anti-angiogenic therapy is one of them. Dr.s Chung and Han from Texas, United States have conducted a mini-review that aimed to explore the present knowledge about the effects of angiogenesis in endometriosis and the anti-angiogenic treatment modalities. The study was published in the journal "Frontiers in Global Women’s…

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How does endometriosis affect the life course of the patients?

Endometriosis, as a chronic disease has impairing effects on women’s lives. Patients carry psychological, social, and work-related burdens along with debilitating physical symptoms. Studies have been performed on these issues at a particular time in patients’ lives, however, only a few of them with small sample sizes looked into the general life-course impairments of the disease. A cross-sectional, multinational survey was carried out online with the aim of understanding how endometriosis impacts patients’ life decisions and goal achievements and their…

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The evaluation of sexual dysfunction in infertile women

Infertility constitutes a serious health problem in women and men worldwide. The most common causes of women’s infertility are reported to be endometriosis and polycystic ovarian syndrome. The prevalence of infertility in women with endometriosis is as high as 50%. Moreover, women with infertility are known to have higher rates of sexual dysfunction compared to healthy ones. A group of researchers from Iran performed a cross-sectional study that aimed to assess the prevalence of sexual dysfunction among women with infertility…

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How possible is it to diagnose endometriosis from a urine sample?

The development of non-invasive diagnostic methods in endometriosis is essential for successful surveillance. Various biomarkers have been used for this purpose, including biomarkers from serum, peritoneal irrigation fluid, endometrial tissue biopsy, and urine. Dr. Chen et al. from Taiwan conducted a study in which they assessed the utility of four different biomarkers in the urine in endometriosis and adenomyosis and compared them with the current gold standard biomarker, serum CA125. The study was published in the April 2022 issue of…

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How reliable are the patient questionnaires in predicting endometriosis?

It is well known that the diagnosis of endometriosis is delayed in the majority of patients throughout the world. The burden that this brings has many effects on the patients’ lives as well as the society. The radiological developments in recent years have expedited the diagnostic process; however, radiological testing on every patient may not be practical, and new screening methods that select patients who are at higher risk need to be developed. Chapron et al. from Paris, France, have…

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 Which of the suggested environmental risk factors are indeed related to endometriosis?

Endometriosis is a complex disease with genetic and environmental factors in its poorly understood pathogenesis. Even though many epidemiological studies in the literature have proposed several risk factors, the lack of clear establishment and modification of these potential risk factors persists. Doctors Zhang and Ma from Shenyang, China, have performed an umbrella review where they analyzed all the systematic reviews and meta-analyses about the association between environmental risk factors and endometriosis and tried to assess the methodology and evidence that…

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Are the studies based on the nationwide databases more accurate?

One of the most common localizations of endometriosis is the ovaries, and therefore, ovarian endometriomas are among the most surgically treated endometriotic lesions. Dr. Roman from Denmark has recently written an editorial about the surgical interventions on ovarian endometrioma and how they should be selected depending on the results from different studies. He compared studies that included the data of one or more surgical teams to studies that were performed using the data of the nationwide databases. It was published…

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What are the most common symptoms of endometriosis and how are they related to age?

Even though the incidence of endometriosis is relatively high and numerous studies are being conducted to elucidate its pathogenesis, it is still a highly underdiagnosed and undertreated disease. The symptoms of the disease are well-known; however, the correlation between the age of onset and the course of the symptoms throughout the reproductive life of the patients has not been evaluated in large cohorts before. Signorile et al. from Italy have conducted an extensive retrospective study that aimed to determine the…

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