Murat Osman

Senior Research Columnist: Murat Osman is a MD candidate at The George Washington University School of Medicine and Health Sciences. His interest in research is primarily focused on Medical Oncology and Radiology. He is also focused on cultivating his passion for medical science and human health through scientific writing and advocacy.

Estrogen receptor splice variants may be associated with endometriosis pathogenesis and clinical severity.

Endometriosis is defined as the presence of uterine stroma and glands outside of the uterine cavity and is one of the leading causes of chronic pelvic pain in women. Thus, understanding key genetic markers of this disease and evaluating those with the risk of progression is a key aim of current research. Estrogen receptors and their variants have been seen to be an important player in the pathogenesis of endometriosis. Briefly, there are two main forms of estrogen receptors. Estrogen…

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Diagnosis and management of adolescent endometriosis

Early onset endometriosis (EOE) is characterized by endometriosis that begins around menarche or early adolescence. Recent evidence suggests that this form of endometriosis may have a different pathogenic origin than that of adult-onset endometriosis. This opinion article suggests that early peritoneal reflux from neonatal uterine bleeding could be a potential factor in the development of EOE. They point out that early endometrial progenitor cells can seed into the pelvic cavity and lay dormant until adolescence, where the disease becomes rapidly…

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Detection and diagnosis of deep endometriosis in the clinical setting

This review aims to evaluate the contribution of imaging techniques including transvaginal sonography (TVS) and magnetic resonance imaging (MRI) to the diagnosis of deep infiltrating endometriosis (DIE). Endometriosis is defined by the presence of endometrial tissue outside the uterus and has been seen to affect 10% of women of reproductive age. Depending on the location and extent of the disease, symptoms may vary and cause infertility. In patients who present with endometriosis-related symptoms (dysmenorrhea, dyspareunia, dysuria, dyschezia, and chronic pelvic…

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Short-term effects of dienogest on ovarian endometriomas

First-line treatment of symptomatic, uncomplicated ovarian endometriosis is the use of progestins with or without estrogens such as Dienogest (DNG). These drugs are used to inhibit ovulation and thus reduce the estrogenic environment in which endometriosis relies upon for survival. Therefore, progestin therapy has been observed to minimize the growth of endometriotic lesions and decrease the symptoms. This study aimed to understand the histopathological effects of DNG on endometriotic cysts of women with ovarian endometriomas. 63 women between the ages…

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Quality of Life in Women with Endometriosis

Endometriosis is a chronic disease characterized by the presence of endometrial tissue outside the uterine cavity. Progression and spread of the disease to other structures may lead to symptoms such as pelvic pain, urinary, and GI dysfunction. Endometriosis has been seen to affect multiple aspects of a woman’s life that are included in the QoL construct. Thus, QoL is an important indicator of what other features of endometriosis’ effects on health need to be addressed. Twenty-six articles were included in…

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Surgical treatment is an excellent option for women with endometriosis and infertility.

Women with endometriosis most often have difficulty becoming pregnant and thus require a combination of endometriosis treatment and infertility techniques to achieve pregnancy. Depending on the severity of endometriotic symptoms, women may or may not need surgical excision of endometriosis to decrease their pain symptoms and achieve a successful pregnancy. This article published by the School of Women’s and Children's Health in Australia aims to review the current understanding of surgical treatment in the workup of fertility for women with…

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What is the role of hormones on the function and development of the brain?

Dr. Sarah L. Berga, Professor, and Chair of Obstetrics and Gynecology Wake Forest School of Medicine aim to talk about the effects of sex hormones such as estrogens and progestins on brain health with an emphasis on the neuroprotective characteristics of estrogens. Throughout her presentation, results from many different studies are explained to highlight that estrogen affects many functions of the brain and that stress and progestins have been found to counteract the neuroprotective functions of estrogens. Dr. Berga begins the…

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Effects of acupuncture for the treatment of endometriosis-related pain

Acupuncture has been seen to offer chronic pain relief most likely due to multiple effects including analgesia and anti-inflammatory changes. Current therapy for endometriosis includes pharmacological and surgical methods. Symptom relief using other supplementary therapies such as acupuncture has been implicated in chronic pain relief, but its effectiveness is still uncertain. The meta-analysis published in PLoS One by Xu et al. aims to summarize the current understanding of acupuncture’s role in the multi-disciplinary approach to treating endometriosis. Using the Cochrane…

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The role of the B lymphocytes in endometriosis: A systematic review

Insight into the role of an inflammatory response in endometriosis has sparked further study into the role of different immune cells and their causal relationship to the pathogenesis of endometriosis. Several recent studies have found an association between aberrant immune response to the presence of endometriosis. This immune-mediated disturbance is thought to aid in the undeterred implantation and proliferation of ectopic endometrial tissue outside the uterine cavity. B cells are cells of the immune system that are activated normally to…

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Is there a risk of developing breast cancer for women with endometriosis?

Understanding the interplay between the development of breast cancer and the presence of endometriosis and vice versa is complex since many risk factors including hormone or genetic variations and medical treatments have a role in each disease process. Thus, parsing out different epidemiological studies with varying results and research methods may yield a clearer picture on the correct association of breast cancer with endometriosis. After pooling studies that concluded in either a positive (direct) or negative (null or inverse) association…

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Migraine and endometriosis?

Many studies have alluded to the relationship between endometriosis and migraines but have often been inconclusive. A migraine is a neurologic disorder in which intense pain, either focal or generalized, occurs with or without associated symptoms such as photophobia, nausea, or menorrhagia. Recent studies have shown that women with endometriosis who also experience migraine headaches have an increased change of mood and pain-related disorders. Thus, understanding this difference is an essential part of developing a multi-factorial approach to treating this…

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An association of negative coping strategies on the presence of chronic symptoms associated with endometriosis

Endometriosis is often a long-term condition that becomes disabling and can affect the quality of life and mental health of many women. One area of endometriosis that needs to be focused on is the psychosocial-related issues of endometriosis and how clinicians can effectively approach recognizing and addressing these issues. Endometriosis has been seen to be associated with an increased risk of many psychiatric symptoms such as depression and anxiety, increased stress, and decreased quality of life. These in addition to…

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Swimming Against the Stream: Is Surgery Worthwhile in Women with Deep Infiltrating Endometriosis and Pregnancy Intention?

Management of Deeply Infiltrating Endometriosis (DIE) is further complicated by the implications of affected patients who plan to become or are pregnant. Optimal management in this situation is not standardized due to a lack of randomized trials comparing primary surgery with first-line in vitro fertilization (IVF) on pregnancy outcomes. Studies have shown that the success rate of assisted reproductive techniques (ART) does not seem to change after having surgery to remove DIE lesions. However, discussion on surgery’s role in improving…

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The role of gene polymorphisms in the pathogenesis of endometriosis

Single nucleotide polymorphisms (SNPs) are the most common type of genetic variations that exist among individuals. These polymorphisms differ by a single nucleotide base pair and are scattered throughout the human genome. Scientists use SNPs as a biological marker to locate and delineate mutations or variations of genes that are associated with disease processes and to assess the genetic similarity between individuals. Most SNPs are completely harmless and do not hurt health or development. However, in some cases, mutations can…

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Are there contributing factors to the co-presence of Irritable Bowel Syndrome and Endometriosis?

Recently, there has been an association between the presence of endometriosis and increased visceral and pressure hypersensitivity, chronic pelvic pain, and other pain and mood disorders. IBS is a functional bowel disorder that is characterized by recurrent abdominal pain or discomfort that improves with defecation. Using different forms of questionnaires including the Birmingham IBS scale, researchers can measure the severity of IBS symptoms. Between December 2013 and April 2015, 373 women with endometriosis were seen in a tertiary referral center…

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With so many imaging tools and modalities, which one should be used for endometriosis?

Intestinal endometriosis affects 5 to 12% of women with endometriosis and commonly presents as dyschezia, rectal bleeding, cyclic defecation pain, constipation, and diarrhea. Currently, surgical treatment includes segmental rectal resection with colorectal anastomosis, but it is often riddled with complications. Thus, identifying such lesions as early as possible may lessen the severity of post-treatment complications and disease symptoms. Transvaginal ultrasonography (TVUS), rectal endoscopic sonography (RES) and magnetic resonance imaging (MRI) can be used to detect and localize intestinal endometriosis. Transvaginal…

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Comprehensive review on the drug delivery options being used for endometriosis and uterine fibroids.

Both endometriosis and uterine fibroids (uterine leiomyomas) contribute to infertility, chronic pain, and dysmenorrhea across the world. Thus, drug delivery methods ranging from contraceptives to biochemical systems based on nanotechnology are currently being used and developed. Specifically, long-acting implantable contraceptives that release selective progesterone receptor modulators (SPRMs), androgens, aromatase inhibitors, gonadotropin-releasing hormone (GnRH) agonists, and immunomodulators are potential options.  The recently published review article in the journal Drug Delivery and Translational Research, entitled "Drug delivery for the treatment of endometriosis…

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Women with endometriosis are increasingly seeking alternative medical therapies for symptom relief

Cyclic premenstrual pain and discomfort (CPPD) encompasses a number of symptoms commonly experienced by many women including premenstrual syndrome (PMS) and is experienced by both women with and without endometriosis. CPPD includes physical and emotional symptoms associated with menstruation including anxiety, depression, bloating, headache, cramping, and breast tenderness. Thus, almost all women have or will experience at least one of these associated symptoms during their lifetime. Some women have found a benefit in using alternative therapies to alleviate some of…

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First-line surgery followed by ART versus ART alone among women with colon-involving endometriosis.

Endometriosis, a disease characterized by the presence of endometrial tissue outside the uterus, may cause pelvic and gynecologic complications that affect fertility in women of reproductive age. Several forms of endometriosis have been observed that are characterized by the varying anatomic spreading of endometriotic lesions. One classification, deep infiltrating endometriosis (DIE), is marked by highly invasive endometriotic lesions to the outer portion of the pelvis and may include the colon. The aim of this study was to examine the correlation…

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Severe Dyspareunia is Related with "Cul-de-sac" and "Uterosacral Ligament" Endometriosis

Endometriosis and especially deep infiltrating endometriosis has been associated with an increased risk of severe dyspareunia. Studies reporting the anatomical sites associated with deep dyspareunia and the severity of pain, and the risk factors of these anatomic sites are incongruent; thus need to be confirmed. In this study, published in the scientific journal "Sexual Medicine", 548 women with either currently diagnosed endometriosis, no confirmed presence of endometriosis, or suspected endometriosis were included. For each patient, the bladder, pelvic floor, cervix,…

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