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. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 03:26 - Endometriosis Beyond the Pelvis 05:17 - Understanding Systemic Symptoms 10:35 - Why Diagnosis Takes Years 12:54 - Key Clues to Endometriosis 14:35 - Emerging Noninvasive Diagnostics 18:13 - Pain Versus Disease Stage 19:33 - Precision Medicine Approaches 24:04 - Treatment Strategies and Follow-Up 27:17 - GnRH Antagonists and Add-Back Therapy 29:45 - Danazol and Surgical Options 34:26 - Future of Immune-Based Therapies 37:49 - Fertility Counseling and Egg Freezing 40:17 - Wrap-Up and Key Takeaways --- 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. --- Resources Clinical 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/ --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app