Endometriosis is a common disease that affects 10-15% of women, and it has the potential to affect nearly every aspect of those women's lives, from their ability to work or build a family to their relationships with significant others, children and everyone around them.

What is endometriosis?

Endometriosis implies the growth of tissue similar to the endometrial lining of the uterus, but outside of the uterine cavity, for example, on the bowel, bladder, ovaries, fallopian tubes, and other areas in the pelvis, and in some circumstances, outside of the pelvis. These endometrial glands respond to the monthly hormonal stimulation from the ovaries, and even make their own hormones, hence growing over time and causing significant inflammation in the pelvis. These glands bleed every month inside of the pelvis, at the time of the menstrual cycle, leading to significant pain with menstrual periods, and ultimately pain throughout the month. Other frequent symptoms include pain with sexual activity, bowel movements and urination. This longstanding inflammation heals with scar tissue (fibrosis) that entraps nerve endings, causing pain, and can affect bowel and bladder function, and in approximately one third of affected women, can lead to decreased fertility.

Not only does endometriosis cause such a large group of women to suffer from a myriad of pain symptoms, but also treatment is oftentimes inadequate or incomplete. To address this gap in patient care, UF Health has distinguished itself as a reputable leader in endometriosis treatment, standing as a Center of Excellence in Minimally Invasive Gynecology (COEMIG) for the last 10 years and offering services that have garnered an increasing number of referrals from all over the state of Florida and beyond.

Led by Nash Moawad, MD, and Amira Quevedo, MD, the UF Health Endometriosis Program and its experts are equipped to treat you and your loved ones, through the expertise of this multi-disciplinary team to tackle the most complex pathology through the least invasive medical and surgical methods with a proven high success rate. Meanwhile, our team will help you minimize complications and the need for repeat operations.

Moawad's practice brings together experts from multiple disciplines to address your condition, specializing in the treatment of chronic pelvic pain and infertility caused by endometriosis. Notably, our program offers fertility-sparing procedures in which we excise all the endometriosis and scar tissue without removing any of the reproductive organs, thus preserving and improving your fertility.

A multi-disciplinary team approach

• Our Center of Excellence collaborates with colorectal surgeons, urologists, and other specialists.
• Our team collaborates with reproductive endocrinologists and infertility specialists. Together, we optimize the conditions for fertility, which maximizes patient's ability to conceive.

Pre-surgery scanning

• We provide state-of-the-art pre-operative imaging. This includes dynamic and 3-D ultrasounds.
• We use standardized MRI protocols. This process is essential for mapping areas of deep infiltrating endometriosis (DIE). A full map allows us to counsel our patients on the best course for treatment. We can assemble the the proper team for the complete excision of endometriosis.

Excellent patient outcomes

We strive to:

• Maintain a very low complication rate
• Maintain low re-operation rates
• Provide excellent patient outcomes

Kaylyn's journey to defeating endometriosis pain

UF Health takes enormous pride in helping patients like Kaylyn Thigpen, a student at Florida State University who turned to the UF Health Endometriosis Program after not finding pain relief elsewhere. Moawad and his team, as always, didn't want to just find a solution for Kaylyn. They empathized with her situation, which saw her as a woman bed-ridden in severe pain and taking a handful of medications during what was supposed to be the best time of her life.

See how Moawad and UF Health gave Kaylyn her life back and helped her defeat severe endometriosis pain:

A growing destination for endometriosis care

Since our designation as a Center of Excellence in Minimally Invasive Gynecology (COEMIG) in 2012, our reputation as a referral center for endometriosis, pelvic pain, fibroids and complex gynecologic surgery has grown at a steady pace.

The designation given by SRC's Center of Excellence accreditation program recognizes institutions and physicians that provide extraordinary care. As a COEMIG-accredited program, we maintain a culture committed to excellence, continuous improvement and patient safety.

In particular, we have evolved into a well-connected and reputable center with expertise in laparoscopic excision of endometriosis, as seen in the graph below. Telehealth has also expanded our abilities to offer our services more broadly nationally and internationally.

A holistic treatment plan

UF Health's Endometriosis Program takes a holistic approach to care and leverages expertise across disciplines. After diagnosis, our physicians often recommend adjunctive therapies, such as pelvic floor physical therapy, integrative medicine and acupuncture, gastrointestinal medicine and pain psychology as needed, as part of a patient's treatment and pain management plan. Our pelvic health physical therapist team will help patients by addressing myofascial pain and muscle spasms resulting from endometriosis and/or surgery. Adhesions can cause pressure on pain sensitive structures. Manual therapy improves mobility in the abdomen which will decrease pelvic pain and improve function by reducing the effects of the adhesions.

The pelvic health physical therapist will also help patients understand pelvic floor anatomy and function, deliver therapy to help restore normal biomechanics, and discuss other areas of the body that could be affecting the pelvic area. Individualized courses of rehabilitation are also offered to patients and guidance is given on exercise programs, diet, and lifestyle changes that will help patients live their most comfortable and productive lives. For more information on pelvic floor physical therapy, please contact the UF Health Rehab Center – Magnolia Park at (352) 265-5200.

When to seek treatment from a medical professional

• If you experience pain before or during your menstrual cycles, during or after intercourse
• If there is blood in your urine or bowel movements
• If you have painful bowel movements
• If you have fertility problems after 12 months of attempting to become pregnant in spite of negative workup for infertility