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. 

Personalized Surgical Strategies for Bowel Endometriosis to Enhance Patient Outcomes

Bowel endometriosis often impacts the rectum or sigmoid colon, causing significant symptoms and reducing fertility. Treatments include hormonal therapy and surgery, with techniques varying widely. Crestani et al., in the leadership of Dr. Horace Roman, conducted a study aiming to reflect on how surgeons can customize the management of bowel endometriosis lesions. The article was published in the June 2024 issue of the journal Best Practice & Research Clinical Obstetrics & Gynaecology. First, they look into the pre-operative care for…

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Evaluating chronic pain through art

Chronic non-cancer pain, affecting up to 31% of the global population, is a complex condition defined by persistent or recurring pain lasting over three months. Despite advancements in understanding chronic pain as a multifaceted interaction of biological, psychological, and social factors, clinical practice often remains narrowly focused on the physiological aspects. In light of these challenges, arts-based research has emerged as a novel approach to capture the complex experiences of individuals living with chronic pain, offering qualitative insights that traditional…

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Causal links between inflammatory regulators and endometriosis phenotypes

Endometriosis is believed to be polygenic and multifactorial, involving processes such as angiogenesis, immune responses, hormonal changes, and progesterone resistance. Inflammation is suspected to play a crucial role in its development, potentially creating a microenvironment that supports ectopic endometrial tissue growth. However, the exact relationship between systemic inflammation and endometriosis is still uncertain. While aberrant inflammation is linked to the development and progression of endometriotic lesions, small sample sizes, and confounding factors have prevented establishing a causal relationship. Wei et al.…

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Endometriosis relief: How vitamins C and E can make a difference

Recent studies indicate that oxidative stress significantly contributes to the onset and progression of endometriosis. High levels of reactive oxygen species (ROS) can cause cellular damage and enhance inflammation, leading to the pain associated with the condition. Antioxidants like vitamins C and E are believed to counteract ROS and help relieve this pain. Bayu and Wibisono from Indonesia performed a meta-analysis aiming to evaluate the effectiveness of combined vitamin C and vitamin E supplementation in reducing pain symptoms in endometriosis…

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The role of coagulation factors and tumor markers in diagnosing advanced stage endometriosis

As a systemic inflammatory condition, endometriosis features elevated proinflammatory cytokines, causing pain, endothelial dysfunction, carcinogenesis, and a hypercoagulable state. Patients with endometriosis show decreased thrombin time (TT) and activated partial thromboplastin time (APTT), alongside increased tissue factor (TF) and fibrinogen levels. Wang et al from Nanjing, China recently conducted a study that aimed to investigate the relationship between inflammatory markers and coagulation factors in stage IV endometriosis and to assess their potential as diagnostic biomarkers. The article was published in…

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Regulatory T cells influence on endometriosis development

While the exact cause of endometriosis is still debated, various theories are being investigated. One approach focuses on the immune system. Regulatory T-cells (Tregs) are crucial in suppressing inflammatory immune responses and preventing autoimmune diseases, allergies, infections, and cancer. Knez et al. from Maribor, Slovenia performed a mini-review regarding the roles of Tregs in various places in the female reproductive tract particularly in endometriosis. It was published in the May 2024 issue of the journal Human Reproduction. They first noted…

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Chronic pelvic pain mechanisms in endometriosis

M. J. Quinn from Shanghai, China wrote an editorial piece in the latest issue of the American Journal of Obstetrics & Gynecology commenting on an article by Gete et al. in which they shared the findings from the Australian Longitudinal Study on Women’s Health, published in American Journal of Obstetrics & Gynecology. Dr Gete et al. showed that women with endometriosis had an adjusted odds ratio of 1.67 for constipation and Dr Quinn commented that this rate would be much higher…

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microRNA signatures as a non-invasive diagnostic tool for peritoneal endometriosis

Using microRNA (miRNA) signatures obtained from bodily fluids as a non-invasive diagnostic tool for endometriosis has recently emerged as a useful method. Endometriosis remains an underdiagnosed disease, especially with subtypes such as peritoneal endometriosis which presents with non-specific symptoms. Researchers from France led by Bendifallah et al. conducted a study using the prospective ENDOmiARN study cohort to evaluate the accuracy of this diagnostic method in saliva samples to identify endometriosis patients with the SPE subtype. The study results were published…

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Endometriosis and mental health disorders: How associated are they?

As with any chronic condition, endometriosis does not only present with physiological problems. The association between endometriosis and mental health issues has been widely studied and it is now known that these patients undergo depression, anxiety, and even bipolar disorder along with the physical symptoms causing a diminished quality of life. It is believed that the mental health burden that these patients are under because of all the things that they go through from delay in the diagnoses to misdiagnosis…

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Endometrial cancer risk in endometriosis: What does the real-world data reveal?

Endometriosis is considered a benign disease, however, studies showed certain somatic mutations in the endometriotic glands indicating a potential link to endometrial cancer. Later, eutopic endometrial tissue was demonstrated to have the same somatic mutations. This resulted in controversial findings as to whether endometriosis actually contributes to increasing the risk of endometrial cancer with meta-analyses and studies revealing different results. Aiming to shed light on the question of whether endometriosis increases the endometrial cancer risk, researchers led by Dr. Farolfi…

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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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