Selma Oransay, MD
Dr. ORANSAY is 35 years experienced clinician in OB/ GYN. She worked in the main national maternity educational hospital of Turkey for 20 years than she moved to İstanbul and worked in private hospitals. Her published articles are mostly on topics of menopause and infertility. She is also experienced as a voluntary OB/GYN doctor in African healthcare program.
Supervised Exercise for Refractory Endometriosis
Fatigue is one of the most disabling yet under-recognized symptoms of endometriosis. Even when standard treatments such as surgery or hormonal therapy are applied, many women continue to struggle with exhaustion, low fitness, and psychological distress. Could structured exercise offer a non-pharmacological way forward? A team led by Dr. Mónica Rodríguez-Rodríguez from the University of Córdoba, Spain, addressed this question in a randomized controlled trial published in the European Journal of Obstetrics & Gynecology and Reproductive Biology. The researchers designed a…
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Endometriosis as a Cardiovascular Risk Factor: A Comprehensive Meta-Analytic Review
Cardiovascular disease is the leading cause of death among women worldwide, accounting for nearly one-third of all deaths. While traditional risk factors include smoking and diabetes, women also face sex-specific contributors such as polycystic ovary syndrome, hypertensive disorders of pregnancy, and premature ovarian insufficiency. Emerging evidence now suggests that endometriosis may be an additional risk factor for cardiovascular disease. Saad and colleagues from Dow University of Karachi, Pakistan, conducted a systematic review and meta-analysis, published in the European Journal of…
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From childhood trauma to adult disease: adversity tied to endometriosis diagnosis
The causes of endometriosis remain incompletely understood, with multiple theories proposed, including retrograde menstruation, immune dysfunction, hormonal and environmental influences. More recently, evidence has suggested that adverse experiences in childhood may contribute to the risk of developing endometriosis later in life. Rostvall and colleagues from Karolinska Institutet, Sweden, investigated this question in a large, nationwide cohort of more than 1.3 million women, born between 1974 and 2001. Using linked national registers, the researchers analyzed the relationship between a wide range…
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Identifying recurrence risk before surgery: Pathological insights in endometriosis
Endometriosis is an estrogen-dependent condition that worsens with each menstrual cycle through chronic inflammation and complex environmental interactions. This progression can lead to deep infiltrating lesions, severe pelvic pain, painful intercourse, gastrointestinal symptoms, and infertility. Laparoscopic surgery remains the gold standard for confirming the diagnosis and removing disease tissue while preserving healthy structures to protect fertility. However, even after such conservative surgery, recurrence rates can reach up to 50% within five years—making prevention a key goal to avoid repeat operations…
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Cervix as a Missing Link in Endometriosis Pathogenesis
The cervix, a 4 cm-long, 2.5–3 cm-wide segment at the lower end of the uterus, plays multiple roles in women’s reproductive health. Lined with mucus rich in antimicrobial peptides, immunoglobulins, immune cells, and exfoliated epithelial cells, it acts as both a barrier and a support structure for pregnancy. Estrogen increases the amount of cervical mucus, decreases its viscosity, and widens mucin pores to facilitate sperm passage, while progestins exert the opposite effect, reinforcing the barrier against bacterial ascent. Beyond these…
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Endometriosis surgery and Anti-Mullerian Hormone Levels
Anti-Müllerian Hormone (AMH), a hormone produced by ovarian granulosa cells, is widely used to estimate ovarian reserve and predict how women may respond to fertility treatments. According to the latest ESHRE (European Society of Human Reproduction and Embryology) guidelines, ovarian reserve should always be assessed in women with endometriosis before planning surgery, as both the disease and its treatment can affect future fertility. A research team led by Horace Roman reviewed 25 years of studies to explore how different types of…
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Comparing Surgical and Non-Surgical Outcomes in Ovarian Endometriosis
Endometriosis often brings chronic pelvic pain, infertility, and diminished quality of life for millions of women. When this condition affects the ovaries—known as ovarian endometriosis or endometriomas—surgical treatment is frequently considered. But how much does surgery actually improve daily life? A recent study from La Paz University Hospital in Spain followed 40 women, including those with operated and non-operated ovarian endometriosis, women with deep endometriosis, and healthy controls. Over a year and a half, researchers assessed their quality of life,…
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Endometriosis Subtypes and Total Fertility Rate: A Nationwide Study
The link between endometriosis and infertility has long been recognized, but large-scale studies comparing fertility outcomes across different subtypes of endometriosis remain limited. Researchers have also sought to understand how surgical treatment affects the likelihood of achieving a live birth. In a nationwide Finnish study, the team led by Dr.Heikinheimo from Helsinki University Hospital analyzed the first birth rate and total fertility rate in women with surgically verified endometriosis, compared to women without the condition. Using data from the Finnish…
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Pelvic nerve endometriosis: Diagnostic and treatment insights.
The exact mechanisms behind pelvic pain in endometriosis remain complex. Current understanding suggests that endometriotic lesions interact with sensory, sympathetic, and parasympathetic nerve fibers, driving inflammation, angiogenesis, and even direct invasion of peripheral nerves. This explains why deep infiltrating endometriosis is strongly linked to severe neuropathic pain. In a recent review published in Insights into Imaging, the team lead by Dr.Pascal Rousset from Lyon Sud University Hospital, France, detailed how MRI can detect endometriotic lesions involving pelvic nerves. The authors…
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Laparoscopic Pudendal Neurolysis: A Solution for Entrapment-Related Pelvic Pain
Pudendal neuralgia is a debilitating condition marked by chronic neuropathic pain in areas innervated by the pudendal nerve, often worsening with sitting and accompanied by urinary, bowel, and sexual dysfunctions. Central sensitization—a heightened nervous system reactivity—affects nearly half of these patients, complicating treatment. In a recent study published in the Journal of Gynecology Obstetrics and Human Reproduction, Renda and colleagues from the Résilience Center in Aix-en-Provence, France, evaluated the outcomes of laparoscopic pudendal nerve decompression in 147 patients with chronic…
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Endometriosis in Youth: Diagnostic and Treatment Insights
Adolescent endometriosis presents unique diagnostic and management challenges due to both patient-related and clinical factors. Young patients often delay seeking care due to inexperience, discomfort discussing symptoms, or normalization of pain. At the same time, clinicians may overlook endometriosis as a potential cause of dysmenorrhea or chronic pelvic pain in this age group. In a recent article published in Abdominal Radiology, Dr. Lampl and colleagues from the Cleveland Clinic highlight the distinct clinical and imaging features of endometriosis in adolescents.…
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Migraine and Endometriosis: Exploring a Comorbid Link
Migraine is one of the leading causes of disability worldwide and disproportionately affects women of reproductive age—many of whom also suffer from endometriosis. While the two conditions may appear unrelated, emerging research suggests they could share common biological and genetic pathways. In a recent review published in Journal of Clinical Medicine, Dr. Lechowicz and colleagues from the University of Warsaw investigated the possible connection between migraine and endometriosis. By analyzing 28 published studies from PubMed and Embase, the team explored…
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Surgical vs. Natural Menopause in Endometriosis
Endometriosis is a chronic, progressive inflammatory disease that causes pelvic pain, painful menstruation, painful intercourse, and infertility. In many cases, surgery is considered due to persistent symptoms, resistance to medical therapy, or invasive disease progression. However, both the disease and its surgical management—particularly procedures like hysterectomy or oophorectomy—can accelerate ovarian failure and lead to early or surgical menopause. A new study led by Dr. Susan R. Chung and colleagues from The University of Queensland analyzed data from five major international…
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Endometriosis: Menopausal Hormonal Options Compared
Endometriosis causes inflammation and often leads to reduced ovarian reserve. Women with endometriosis are at a higher risk of entering menopause earlier—either naturally or due to surgery. To help preserve ovarian function and manage symptoms, clinicians often prescribe long-term hormonal treatments. One such medication is dienogest, a fourth-generation synthetic progestin known for its tolerability and effectiveness. A team of researchers from Santa Maria Hospital in Terni, Italy, led by Dr. Piacenti, conducted a systematic review to compare dienogest with combined…
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Low Anterior Resection Syndrome (LARS) Risk Following Rectosigmoid Endometriosis Surgery
Colorectal surgery for deep endometriosis can sometimes lead to a condition called "Low Anterior Resection Syndrome (LARS)" — a combination of bowel symptoms like frequent urges to defacate, stool fragmentation, and fecal incontinence. These symptoms occur due to impaired rectal reservoir function, altered motility, and possible damage to nerves or structures involved in bowel control. Although several factors are known to increase the risk of LARS, such as a short distance between the anastomosis and the anal verge, previous radiotherapy or chemotherapy, a surgical…
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Abortion and Endometriosis: No Causality Found
Endometriosis is a chronic condition that can lead to infertility or delayed childbirth, often accompanied by symptoms such as prolonged menstrual bleeding, dysmenorrhea, dyschezia, dyspareunia, and chronic pelvic pain. Among its many debated associations, spontaneous abortion (miscarriage) has frequently been suggested as a possible consequence of or contributor to endometriosis, though a causal relationship has never been clearly established. To address this question, a research team led by Drs. Zhou and Peng from Peking University conducted a large-scale genetic study…
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Impact of OC-Induced Mood Lability on Treatment Adherence in Endometriosis
Endometriosis is associated not only with chronic pelvic pain, dyspareunia, dyschezia, dysmenorrhea and infertility but also with a significantly increased risk of mood disorders,anxiety and particularly depression. The global depression rate of women in the reproductive period is between 4.5% and 7%, but for women are diagnosed with endometriosis this is higher. Oral contraceptives (OCs), including combined estrogen-progestin and progestin-only pills, are commonly prescribed to manage endometriosis-related symptoms. However, emerging evidence suggests that OCs may contribute to mood lability and exacerbate underlying…
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Revisiting the Role of Androgens in Endometriosis Pathology
In In a typical menstrual cycle, the endometrium is regulated by hormones like estrogen and progesterone. After ovulation, rising progesterone levels help the endometrial stroma transform into a receptive state, allowing a fertilized embryo to successfully implant. This process, called endometrial receptivity, is essential for pregnancy. The influence of androgens, commonly known as male hormones, on the female reproductive system is less understood. In a recently published review in Medical Molecular Morphology, the research team led by Dr.Kajihara from Saitama Medical University in Japan explore…
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Clinical Endometriosis Despite Negative Histology: A Diagnostic Dilemma
To diagnose endometriosis, clinicians typically rely on a combination of symptoms, noninvasive imaging, and histopathological examination of lesions seen during surgery. However, in some cases, even when visible lesions suggest endometriosis, histological confirmation is not obtained—leaving the diagnosis uncertain. This study aimed to investigate the clinical characteristics of women with laparoscopically diagnosed superficial peritoneal endometriosis who lacked histologic confirmation, compared to those with histologically proven ones. Reis et al., from the Centre Medical Faculty at the University of Paris, conducted…
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Psychological and Clinical Impact of Adolescent Endometriosis
Alarmingly, two-thirds of individuals with endometriosis report symptom onset before the age of 20, underscoring the importance of timely recognition and intervention for adolescent endometriosis. In adolescent age group, severe menstrual pain is the most common symptom, often interfering with daily activities, social life, and school attendance. Unfortunately, this pain frequently responds poorly to common treatments like non-steroidal anti-inflammatory drugs or oral contraceptives. Other symptoms include dysuria, dyspareunia, abnormal bleeding, gastrointestinal discomfort, and infertility. Delays in diagnosis are common due…
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