Ep. 133 Advances in Endometriosis: Diagnosis & Management with Dr. Hugh Taylor

Advances in endometriosis research are reshaping how clinicians diagnose, understand, and treat this complex multisystem condition. On this episode of BackTable Women’s Health, Dr. Nicole Faulkner welcomes Dr. Hugh Taylor for an in-depth discussion of the systemic nature of endometriosis, including its metabolic, psychological, and cardiovascular effects, as well as central pain sensitization and bowel and bladder symptoms. They also explore how animal models and biomarkers like microRNAs are deepening our understanding of these connections.

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Timestamps

00:00 - Introduction03:26 - Endometriosis Beyond the Pelvis05:17 - Understanding Systemic Symptoms10:35 - Why Diagnosis Takes Years12:54 - Key Clues to Endometriosis14:35 - Emerging Noninvasive Diagnostics18:13 - Pain Versus Disease Stage19:33 - Precision Medicine Approaches24:04 - Treatment Strategies and Follow-Up27:17 - GnRH Antagonists and Add-Back Therapy29:45 - Danazol and Surgical Options34:26 - Future of Immune-Based Therapies37:49 - Fertility Counseling and Egg Freezing40:17 - Wrap-Up and Key Takeaways

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More about this episode

Given that many patients wait years for a diagnosis, Dr. Taylor emphasizes the importance of presumptive clinical diagnosis and selective imaging to expedite treatment. He highlights emerging biomarkers that may offer more noninvasive diagnostic options and help clarify pain mechanisms. The conversation reviews current management strategies, including continuous oral contraceptives, the challenge of progestin resistance, and the promise of blood-based tests to predict treatment response. They also discuss GnRH antagonists, Danazol, surgery for refractory cases, and future directions such as immune-based therapies targeting the inflammation and immune dysfunction at the root of endometriosis.

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ResourcesClinical evaluation of the oral gonadotropin-releasing hormone-antagonist elagolix for the management of endometriosis-associated pain: https://pubmed.ncbi.nlm.nih.gov/31434540/

Circulating microRNAs as potential biomarkers for endometriosis: https://pubmed.ncbi.nlm.nih.gov/25772772/