CHARLOTTE – Since she was 12 years old, Emily Chandler had been told her excruciating pelvic pain was “just the way it was.”
In high school, Emily would sometimes miss one day a month due to menstrual pain. She was told by many that it was just part of being a woman. She went on birth control pills to help the symptoms, which minimally relieved her pain.
She was unknowingly struggling with endometriosis, a disease that occurs when tissue similar to the uterine lining grows outside of the uterus, causing pain, inflammation and often infertility.
Emily had almost given up hope of feeling better, having less pain and even having a child.
“I didn’t understand the science behind it all,” Emily said. “I wish I knew then what I know now. I would have fought a little more and found help earlier.”
With the help of Dr. Smitha Vilasagar, with Atrium Health’s Women’s Center for Pelvic Health, Emily is now living with minimal pain and symptoms from endometriosis.
The fight for a family
Before her first visit with the Atrium Health care team, Emily and her husband had been talking about trying to conceive. They tried naturally for over a year, but continued to have trouble. Finally, they turned to the Women’s Institute at Atrium Health. And through the care of Atrium Health, Emily conceived through a fertility treatment. Emily gave birth to Bratton in 2011.
Six years later, the Chandlers were ready for a second child. They tried on their own for months. After a routine OB/GYN appointment, Emily was told about a cyst on her left ovary, known as an endometrioma.
She researched endometriomas and found those with an endometrioma had a 90 percent chance of also having endometriosis implants elsewhere in the pelvis, causing pain, inflammation and scarring in the pelvis.
Endometriosis is estimated to affect up to 10 percent of women and occurs more frequently in women with infertility.
Even with this diagnosis, Emily was told she could continue fertility treatment.
“We had three IUIs with no success,” she said. “And with each cycle, my endometrioma had grown.”
After years of frustration, Emily’s health was taking an emotional toll on the couple.
“Endometriosis can have a detrimental effect on a woman’s quality of life,” said Dr. Vilasagar, a gynecologic surgeon specializing in the treatment of endometriosis. “The associated symptoms are often debilitating, affecting all aspects of a woman’s life, including her personal family and social life, career, mental well-being and sexual health.”
In addition to the psychological struggles she was facing, Emily started experiencing more pain than she ever had before. Her pain was so intense, she had to make several trips to the emergency department within three weeks. Her primary care physician told her to see Dr. Vilasagar for specialized treatment.
The next steps
Emily’s hope was restored after meeting Dr. Vilasagar for the first time.
“She was very attentive and reassuring,” Emily said. “She thoroughly explained what was going on to me and my husband. She listened to every word I had to say and looked me in the eye.”
Dr. Vilasagar told Emily she was committed to helping her feel better.
“After struggling for so many years…to hear someone say that was an answer to my prayers,” Emily said.
In April 2018, Emily underwent laparoscopic excision of endometriosis surgery. This minimally invasive surgery is performed through tiny incisions on the abdomen to remove all implants of endometriosis, endometriomas and the resultant scarring, while preserving the uterus, ovaries and fallopian tubes. The benefits of a minimally invasive approach to this surgery include discharge home the same day, shorter recovery times and minimal scarring.
“The goal of Emily’s surgery was twofold: to achieve pain relief but to also preserve fertility – remove the endometriosis and endometrioma but not remove the healthy tissue,” Dr. Vilasagar said.
Emily could tell a different after waking from surgery. She no longer had pain with bowel movements or an urgency to urinate.
Emily’s surgery was quite challenging as she had developed endometriosis throughout her entire pelvis, in addition to the endometrioma cyst. Emily has essentially been pain-free since her surgery.
“It breaks my heart that people have to deal with this, but I want people to know there is hope,” Emily said.
There is hope
Some women may feel their experiences are common, and some women are told that their symptoms are normal. Other women may believe that these issues are too taboo to discuss.
“Women can feel isolated by their experiences of pelvic pain and suffer in silence due to fear of discussing these private topics. I want to reassure any woman who is suffering that they are not alone, and it is imperative to start an open dialogue about these issues with your primary care doctor or OB/GYN,” Dr. Vilasagar said. “Women should discuss any symptoms that are negatively impacting their quality of life, such as heavy periods, pain with periods or with intercourse, or if they are experiencing pain as well as difficulty becoming pregnant.”
If any of these symptoms sound familiar, women can be referred to a specialist to have a thorough evaluation, counseling and discussion of treatment options. For women suffering from chronic pelvic pain, there are often multiple conditions that are contributing to her symptoms. It is important to diagnose and address all of these conditions. There is a multi-disciplinary approach to care of these patients at Atrium Health.
Atrium Health provided this story.