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. 

 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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Cannabis use in the management of endometriosis-related pain during the COVID19 pandemic

Pain management in endometriosis has been challenging owing to many reasons. Since the pathways that cause pain in endometriosis have not been elucidated extensively, the medical and surgical management of pain remains to be symptomatic. Alternative pain management methods have also been investigated to provide a better quality of life. With the decrease in health care access due to the COVID-19 pandemic, self-management of pain control has been a part of those suffering from endometriosis pain. Cannabis consumption has been…

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Prolactin receptor antibodies: A novel treatment proposal for endometriosis

Prolactin, a hormone that also acts as a proinflammatory cytokine through its receptor PRLR has been shown to be involved in endometriosis pathogenesis. Previous studies reported that women suffering from endometriosis had elevated prolactin levels. Also, in experimental studies done on mice, the drugs used to lower prolactin levels, such as dopamine receptor agonists, have succeeded in reducing the endometriotic lesion burden. Otto et al. from Germany have performed an experimental study on murine endometriosis models targeted to evaluate the…

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A quick insight into the latest research on endometriosis diagnosis and management

Endometriosis research has been expanding with many new studies ranging from new techniques and markers in diagnosis to updates in clinical management and treatment of the disease. The journal Frontiers in Surgery recently brought together articles that reflect important and novel matters on endometriosis and its management. Dr. Ayoubi from France has written an Editorial summarizing the essential findings that these articles have provided in the November 2021 issue of the journal. Firstly, the article by Kitajima et al. reported…

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Risk of cardiovascular disease in endometriosis patients

A well-known fact about endometriosis is the inflammatory processes that underlie its pathophysiology. The inflammatory markers have been thought to play a role in many additional disorders in endometriosis patients. One of the primary markers of inflammation is C-reactive protein which was shown to be an indicator of infection, inflammation, and tissue damage, and is thought to be associated with increased risks of cardiovascular disease. Fibrinogen and homocysteine take part in inflammation and thrombosis and have been shown to increase…

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Which surgical technique is best for rectal endometriosis?

One of the common sites for deep endometriosis is the intestines, with a rate of 3-37%. Intestinal endometriosis constitutes a serious cause of gastrointestinal symptoms, pain, and the alteration of the quality of life, with the rectum and sigmoid colon being affected in the majority of the cases. Although clinical treatment may be beneficial in terms of reducing the lesion sizes and providing some symptom relief, the recurrence rate is high. Surgical intervention is deemed necessary in symptomatic patients.  The best…

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Surgery before in-vitro fertilization – Is it beneficial in patients with deep endometriosis?

Deep pelvic endometriosis is thought to be related to infertility by altering the pelvic environment and anatomy due to pelvic adhesions, and the changes in endometrial receptivity contribute to it. The discussion on whether the surgical intervention was beneficial started when the European Society of Human Reproduction and Embryology and the European Society of Gynaecological Endoscopy stated that the resection of deep endometrial nodules did not ameliorate the fertility outcomes.  Drs Khan and Lee from India and Taiwan conducted a…

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Quality of life assessment in women with endometrioma

Like most chronic diseases, endometriosis poses a significant risk of diminishing the quality of life in patients suffering from it, particularly with its most considerable symptom; chronic pelvic pain. Although it is known that endometriosis is more common in East Asian women compared to Caucasians, not many studies in the literature have investigated the quality of life in these patients. With this aim, researchers from Khon Kaen, Thailand, conducted a cross-sectional study using the Endometriosis Health Profile – 30 (EHP-30)…

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The Role of Endometrial Cytokines on the Infertility in Endometriosis Patients

The intrauterine microenvironment and underlying immunological mechanisms in endometriosis pathogenesis have been a popular research topic, mainly due to the efforts to comprehend the reason to elucidate infertility that these patients suffer from. Because of their superiority to other immune cells in terms of presence during the endometrial cycle, uterine natural killer cells often attract more attention among all immune cells. They harbor specific functions in homeostasis, embryo implantation, and the continuation of pregnancy. These functions are performed differently from…

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How likely is it to get pregnant and have a baby after undergoing surgery for high stage endometriosis?

As one of the most common causes of infertility in women, endometriosis might be surgically interfered with depending on the stage. For Stage I and II endometriosis, surgery is recommended in the latest guidelines to ameliorate fertility rates, however, there is not a consensus for advanced-stage endometriosis (stage III and IV). Wang et al. reported a retrospective study in which they evaluated the postoperative pregnancy and live birth outcomes of patients with stage III and IV endometriosis. The results of…

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Physical activity and exercise in reducing endometriosis symptoms

The treatment modalities to date on endometriosis have focused on the symptomatic relief and management of chronic pain. Hormonal suppression sometimes shows intolerable side effects and is known to lose effect after some time. Surgical interventions may not provide a permanent solution. Non-pharmacological and less interventional supportive treatment methods have been getting popular.  Physical activity and exercise for relieving the symptoms related to endometriosis have been recommended in the clinical guidelines as new approaches. Tennfjord et al. from Norway have…

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The quality of life and mental health in endometriosis patients

One of the most important aspects of having a chronic illness comes with its relative effect on the patients’ quality of life and mental health status. Being among the most debilitating diseases in women in the reproductive period, endometriosis is known to alter the quality of life with its clinical symptoms such as pain and infertility. Studies have shown that women with endometriosis display a lower health-related quality of life, and a higher incidence of depression and anxiety. The relationship…

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A novel target proposal in endometriosis: Phoenixin

As well as being a hormone-dependent reproductive system disorder, endometriosis is known to be multifactorial, which makes its etiopathogenetic mechanisms even harder to understand. Many new targets have been vastly evaluated with the hope of finding a new diagnostic test and developing alternative and better treatment methods. A new neuropeptide secreted from the anterior hypothalamus called Phoenixin (PNX) was recently brought to light with its effects on regulating the hypothalamic-pituitary-gonadal (HPG) axis, reproductivity, cardiac health, nutrition, memory, pain, and anxiety.…

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Emotions on the 'Surgery Requirement' in patients with bowel endometriosis

Endometriosis is known to have many adverse effects in patients’ lives such as a significant decrease in the quality of life, psychosocial problems, loss of productivity and focus while working. With the constant chronic pain, the patients mostly present with psychological matters. Patients diagnosed with deep endometriosis on the other hand, also suffer from additional psychological stress that is brought on by the necessity of having to have surgery. Researchers from São Paolo, Brazil performed a cross-sectional observational study on…

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Matrix metalloproteinases and their role in endometriosis

The extracellular matrix harbors important macromolecules such as collagen and glycoproteins which are required for tissue remodeling, differentiation, and homeostasis. The main group of enzymes responsible for these properties is called matrix metalloproteinases (MMPs). It has been proven that MMPs play pivotal roles in tissue remodeling, therefore may contribute to invasion and angiogenesis. Researchers from China and Singapore have published a review study that compiles the research on MMPs and their significant roles in endometriosis pathogenesis, which was published in…

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Efficacy of cannabis on endometriosis symptoms

Endometriosis is related to a wide range of symptoms that affect the quality of life of patients in many aspects. Studies have shown malfunctions in the endocannabinoid system in endometriosis patients which led to the idea to target this pathway in the treatment of endometriosis-associated pain. In a research study performed by Sinclair et al. from Australia and the United Kingdom the consumption of cannabis in order to alleviate endometriosis-related symptoms was analyzed. The data was tracked using a smartphone…

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A novel in-vitro endometriosis model with KRAS and PIK3CA mutations

A plethora of research has been ongoing to illuminate the pathogenesis of endometriosis which is a multifactorial disease. These studies have proven the association between some mutated cancer driver genes and endometriosis, and links between certain cancers such as ovarian endometrioid carcinoma and clear cell carcinoma. The oncogenes KRAS and PIK3CA are among the most commonly mutated genes in normal endometrium and endometriosis and are thought to initiate the pathogenetic mechanisms that result in endometriosis. With the aim of a…

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Cross-cultural translation and adaptation of an endometriosis survey

Endometriosis is a disease that presents heterogeneously which makes it hard to identify a causal relationship. A patient-based questionnaire called Endometriosis Participant Questionnaire (EPQ) has been originated by The World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonization Project. It was aimed to increase the quality and quantity of the data collected from English-speaking countries and help in the planning and explication of large-scale studies. Since then, the survey was translated into several languages, however, the adaptation of the survey…

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