CENTER FOR TREATMENT AND
STUDY OF ENDOMETRIOSIS

FEMALE REPRODUCTIVE ORGANS
The normal female has two ovaries, two fallopian tubes, the uterus, and the vagina.  The lining of the uterine cavity is called endometrium.  The ovaries produce an egg each month (ovulation) and secrete female hormones (estrogen and progesterone).
 
WHAT IS ENDOMETRIOSIS
The endometrium is the lining of the uterus. This lining regurgitates into the abdominal cavity during the menstrual period through the fallopian tubes.  This endometrial tissue (cells) in response to female hormones (estrogen and progesterone) sometimes grows outside the uterus, usually within the abdominal cavity. It can appear on the ovaries, fallopian tubes, and less commonly in the rectum, vagina, intestines, bladder and elsewhere. The tissue causes cyst formations and adhesions (scar tissue).

Since the tissue continues to respond to reproductive hormones, bleeding can occur from this displaced tissue during the menstrual cycle, causing the symptoms like painful period (cramps), painful sex and pelvic pain. Other symptoms include spotting between periods, abdominal swelling, and diarrhea, blood in the urine or stool and others depending on which organs are involved.  Symptoms may vary from woman to woman.  The symptoms may resolve with treatment and then return later.  They usually disappear after treatment.

Endometriosis is a leading cause of painful periods (dysmenorrhea), chronic pelvic pain and infertility. However, there may be reasons other than endometriosis for why you are feeling pain. Endometriosis is diagnosed by history, examination, ultrasound (sonogram), computed tomography (CT) scan, magnetic resonance imaging (MRI) and laparoscopy.  If you have these symptoms you can contact us for diagnosis and treatment.

If you have surgically diagnosed endometriosis, have painful periods, pelvic pain and are not trying to become pregnant within the next two years; please contact us to find out if you are eligible for free treatment, study procedures and visits.

How is endometriosis treated?
The choice of treatment depend upon the severity of the symptoms, location of endometriosis, and if you want to get pregnant.
1. Surgical treatment.
2. Medical treatment.
3. Combination of surgery and medical treatment.






 
 
PERSONNEL

Ozgul Muneyyirci-Delale, M.D.
Associate Professor
Director, Division of Reproductive Endocrinology
Director of Reproductive Endocrine Laboratory
Department of Obstetrics and Gynecology
SUNY Downstate Medical Center
Attending and Lecturer, Kings County Hospital Center
Diplomate, American Board of Obstetrics and Gynecology
Board Certified in Reproductive Endocrinology and Infertility

Selected Publications and Presentations
1.
Stovall TG, Muneyyirci-Delale O, Summitt RL Jr, Scialli AR: GnRH agonist and iron versus placebo and iron in the anemic patient before surgery for leiomyomas: A randomized controlled trial. Obstet & Gynecol, 86:65, 1995.
2. Muneyyirci-Delale O, Karacan M: The effects of norethindrone acetate in the treatment of symptomatic endometriosis. Intl J of Fertility and Women's Medicine 43:24, 1998. (Distributed to more than 15,000 physicians by ESI Lederle and The Endometriosis Association)
3. Muneyyirci-Delale O, Neil G, Maiman M, Serus E, Gordon D, Sedlis A: Endometriosis with massive ascites. Gynecologic Oncology 69:41-46, 1998.
4. Muneyyirci-Delale O, Karacan M, Nacharaju V: Hormonal treatment of bilateral proximal tubal obstruction. Intl J Fertility & Women's Medicine 44:204, 1999.
5. Muneyyirci-Delale O, Jalou S: Long-term treatment of symptomatic endometriosis with norethindrone acetate. Clin J of Women's Health 13:28:45, 2001.
6. Muneyyirci-Delale O, Jalou S, Rahman M, Nacharaju V: Can we decrease breakthrough bleeding in patients with endometriosis on norethindrone acetate? Intl J of Fertility & Women's Medicine 48(1):32-36, 2003.
7. Muneyyirci-Delale O, Popilevsky F, Hadavant H, Nachraju V, von Gizycki H, Abulafia O: Is teenage dysmenorrhea associated with displacement of the cervix and uterus? Presented at the Society of Gyn Investigation Annual Meeting, March 2005.


Mudar Dalloul, M.D.
Clinical Assistant Professor
Director, L & D
Department of Obstetrics and Gynecology
SUNY Downstate Medical Center
Diplomate, American Board of Obstetrics and Gynecology

Selected Publications
1.
Muneyyirci-Delale O, Dalloul M, Nacharaju VL, Altura BM, Altura BT: Serum ionized magnesium and calcium in women after menopause: Inverse relation of estrogen with ionized magnesium. Fertility and Sterility 71(5):869-822, 1999.
2. Muneyyirci-Delale O, Nacharaju VL, Dalloul M, Jalou S, Rahman M, Altura BT, Altura BM: Divalent cations in women with PCOS: Implications for cardiovascular disease. Gynecologic Endocrinology 15:198-201, 2001.
3. O'Shaughnessy A, Muneyyirci-Delale O, Nacharaju VL, Dalloul M, Altura BM, Altura BT: Circulating divalent cations in asymptomatic ovarian hyperstimulation and in vitro fertilization patients. Gynecol Investigat 52(4):237-42, 2001.

Research Associates
Rudolph Parris, MPH
Nanna Osei-Tutu, B.S.

Vijaya L. Nacharaju, Ph.D.
Dr. Nacharaju had nine years of research experience at The Population Council, Rockefeller University, in the area of steroid metabolism involving metabolism of cortisol the stress hormone. She continued her research at Downstate Medical Center giving attention to metabolic aspects of cortisol in reproductive endocrinology. She published more than 40 research articles in peer reviewed journals.
Dr. Nacharaju is in charge of the reproductive endocrinology laboratory, performing different female reproductive hormone assays. She also is in charge of the gas chromatography and mass spectral analysis, obtaining steroid hormone profiles in normal and abnormal conditions.

Laboratory Personnel
Claudette Gordon, M.S.
Lian-fu Yang, B.S.

Other Personnel
Aggie Smith, CNM
Pamela Litman, CNM

Research Coordinator
Jessie Walsh

Secretary
Alice McLaughlin

Research Pharmacy
Motria Mishko, R.Ph.
Research Pharmacist


Statistician
Hans von Gizycki, M.S.
Clinical Assistant Professor
Member of Scientific Computing Center

Consultants
Pamela Stratton, M.D.
Principal Investigator, Endometriosis Research
Chief, Gynecology Consult Service
NICHD/NIH

Jay M. Fleisher, Ph.D.
Epidemiologist and Biostatistician
Associate Professor
Nova Southeastern University


 



RESEARCH ACTIVITIES

1. ENDOMETRIOSIS STUDY (NIH SPONSORED)

If you have active endometriosis diagnosed by surgery with menstrual cramps (period pain) and do not plan to become pregnant within the next 2 years, Dr. Muneyyirci (Dr. Muney) and her group will be comparing two well-established medications used for the treatment of endometriosis. Both medications have been on the market for more than 15 years. If you enroll in the study, you will receive one of the two treatments.

The medications, study procedures and testing will be free.

QUALIFIED PARTICIPANTS:
— Women 18 years of age and older/ pre-menopausal
— Regular periods with no menopausal (change of life) symptoms
— Surgically diagnosed endometriosis
— No plans of becoming pregnant within the next 2 years

Contact Us: reproendo@downstate.edu

718-270-2101 or 718-270-1364


2. Treatment and Study of Primary Dysmenorrhea (period cramps). In the future we will give additional information.

3. The division has several research projects for reproductive endocrine conditions.


 



LABORATORY RESEARCH

— Several laboratory research projects related to endometriosis.
— Many research projects related to reproductive endocrine and gynecological conditions.



 



EDUCATIONAL ACTIVITIES

Dr. Muneyyirci-Delale gives lectures to doctors, residents, medical students, physician assistants, nurse practitioners and lay persons about endometriosis and other topics related to reproductive endocrinology and infertility.

The recent lecture schedule includes:
— Obstetrics and Gynecology Review Course
— Endometriosis
— Dysemenorrhea (painful period : cramps)
— Uterine Leiomyomata (myoma, fibroid uterus)
— Dysfunctional Uterine Bleeding (abnormal uterine bleeding)
— Premenstrual Syndrome (PMS)

Lecture to community on “Endometriosis” sponsored by Department of Family Practice.
Program with Dr. Deas
Lecture to lay persons “Endometriosis”, 9/14/05, 6:00 p.m.

Future Events

 



CLINICAL CARE

We offer medical, surgical and combined treatment for endometriosis and infertility.

Contact Us: reproendo@downstate.edu

718-270-2101 or 718-270-1364


 



ADDITIONAL RESOURCES

Endometriosis Association: www.EndometriosisAssn.org

NIH: www.nih.gov

American Society for Reproductive Medicine (ASRM): http://www.asrm.org

Endometriosis Research Center: http://endocenter.org




Last updated: Tuesday, October 23, 2007