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.
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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From Probe to Procedure: UBESS Enhances Preoperative Planning
A new ultrasound-based system called UBESS (Ultrasound-Based Endometriosis Staging System) is designed to help surgeons estimate how complex endometriosis surgery might be before it happens. This system is used during a routine transvaginal ultrasound and classifies patients into three stages from least complex UBESS I, to most complex UBESS III based on the extent of disease visible on imaging. In the study by Dr. Ebrahimi and colleagues from Tehran University of Medical Sciences that will be published in Fertility and Sterility. examined…
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Traumatic experiences in early life and later development of endometriosis.
Endometriosis is a chronic, progressive condition affecting 10–15% of women worldwide, yet current treatment options remain limited, and diagnostic tools are inadequate. This shortfall stems largely from an incomplete understanding of its underlying pathophysiology. In recent years, researchers have begun to explore the psychosocial dimensions of the disease, particularly its potential association with early-life trauma. Childhood maltreatment—including emotional neglect and sexual abuse—has long been recognized as a risk factor for poor mental health outcomes in adulthood and may also contribute…
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Endometriosis-Related Infertility: Focus on Oocyte Quality
Fertility and pregnancy success depend on three key factors: the number of oocytes, ovulation, and oocyte quality. While tests such as anti-Müllerian hormone levels and antral follicle counts can estimate oocyte quantity and ovulation, oocyte quality can only be assessed during in vitro fertilization. Research has shown that women with endometriosis often experience lower rates of oocyte maturation, fertilization, embryo development, and implantation, along with a higher risk of miscarriage. Improving oocyte quality is therefore a critical step before initiating…
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Converting Enzian into AAGL2021: A Step Toward Unified Staging
The revised American Society of Reproductive Medicine (rASRM) is the most widely used classification for endometriosis. This classification is easy to use but has some limitations, especially in describing deep endometriotic lesions and pain severity. On the other hand, the Enzian classification can code peritoneal, ovarian, deep endometriosis, and adenomyosis. This latter classification consists of letter and number coding rather than staging. In 2021, the American Association of Gynecologic Endoscopists introduced another staging classification named AAGL2021. To investigate the surgery-based…
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Physical Activity Boosts Self-Perception in Young Women with Endometriosis
Endometriosis affects millions of women worldwide, causing chronic pelvic pain, infertility, and significant disruptions to daily life. Beyond the physical pain, this condition can severely impact a woman’s self-esteem and body image. Since body perception is closely tied to physical appearance and abilities, engaging in physical activities can be a powerful way to boost self-image and overall well-being. A recent study by Coquinos et al. from the Sports Health Science Institute at Paris University explored how physical activity affects body…
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Linking Endometriosis to Age-Related Macular Degeneration
The macula, the central region of the retina, is crucial for sharp central vision and the color perception. Age-related macular degeneration (AMD) primarily affects this area and progresses through different stages, ranging from early to advanced forms. AMD has two main types: dry AMD and wet AMD. In the wet form, inflammation and abnormal blood vessel growth, or angiogenesis, play a key role in causing significant vision loss. These irregular blood vessels beneath the retina can leak fluid, leading to…
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Diaphragma central tendon and catamenial pneumothorax
Endometriosis typically involves ectopic endometrial tissue in pelvic organs, such as the bladder, ovaries, and uterine ligaments, leading to symptoms like dysmenorrhea, dyspareunia, and dyschezia. A rare form occurs in the diaphragm, causing catamenial pneumothorax. Management often includes hormone therapy or ovarian suppression, with surgery beneficial, especially for women desiring pregnancy. Inoue et al., from Kishiwada Tokushukai Hospital, Japan, reported the management of a case of a young unmarried woman with catamenial pneumothorax (a condition where lung collapse is associated…
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Impact of Menstrual Cycle on Cognitive Function in Midlife Women
Dementia, which affects women at more than 1.7 times the rate of men, continues to be a growing health concern, with potential links to hormonal changes. Estrogen, known for its neuroprotective effects, influences cognitive functions such as verbal memory, fluency, and fine motor skills. Disruptions in the hypothalamic-pituitary-ovarian axis and hormone imbalances can reduce estrogen levels, potentially contributing to cognitive decline. A recent retrospective study by Soria-Contreras et al. from Harvard T.H. Chan School of Public Health examined the relationship…
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Impact of appropriate surgery on endometriosis-related infertility
Endometriosis surgery by removing all visible lesions and repairing damaged tisue is important to build normal pelvic anatomy. It is still difficult to predict postoperative pregnancy rates among women with endometriosis who suffer from infertility. This retrospective study, conducted by Tahmasbi Rad et al. from the Department of Obstetrics and Gynecology at the University of Frankfurt, evaluated factors influencing postoperative pregnancy rates in women with endometriosis. The study followed 102 women who underwent laparoscopic surgery at a tertiary clinic between 2007…
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The current management of endometriosis-related infertility.
Endometriosis is a chronic disease affecting women of reproductive age, often presenting with pelvic pain such as dyspareunia, dyschezia, and dysuria, or inertility, and significantly impacting quality of life. Management should be individualized based on symptoms, reproductive goals, age, and patient preference. The choice between surgery and ART depends on clinical factors, with first-line IVF generally recommended for asymptomatic deep endometriosis cases.Colombi et al., from the University of Siena, reviewed endometriosis-related infertility, focusing on surgical roles by analyzing 1,035…
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Impact of Nerve Preservation During Parametrectomy on Urinary Retention in Deep Endometriosis Surgery
Deep infiltrating endometriosis (DIE) is the most advanced form of the disease, characterized by lesions penetrating deeper than 5 mm. Surgical treatment requires a meticulous approach to minimize functional complications. Deep lesions involving the parametrium, uterosacral ligaments, and anterior rectal wall may affect the inferior hypogastric nerve fibers, leading to a high incidence of postoperative voiding dysfunction. These fibers are anatomically located medially to the internal iliac arteries and caudally where the uterine artery crosses the ureter. Thus, preserving the…
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Pre-Diagnosis Hospital Utilization Patterns in Women With Endometriosis
Endometriosis is commonly associated with symptoms such as painful periods, chronic pelvic pain, and infertility. Diagnosing the condition is challenging due to symptom overlap with other gynecologic and gastrointestinal disorders, as well as the need for advanced imaging or laparoscopic techniques. Many women report a prolonged diagnostic process involving repeated visits to multiple clinics. Although previous studies have shown that women with endometriosis utilize healthcare services more frequently, little is known about their hospital contacts prior to diagnosis. To address…
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