Hugh Taylor has spent decades studying the endometrium, the lining of the uterus. Yet it was his patients who first drew his focus to endometriosis—a condition that remains widely misunderstood.
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. It can cause severe pain, infertility, and other health complications. In the United States, it affects roughly one in 10 women of reproductive age. Despite its prevalence, questions about its causes and treatments remain largely unanswered.
“Being a reproductive endocrinologist, I often see women with endometriosis because of their pain or infertility,” said Taylor, the Anita O’Keeffe Young Professor and Chair of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine. “It was frustrating to see so many patients suffering for years before receiving an accurate diagnosis.”
Taylor, who also serves as professor of molecular, cellular, and developmental biology at Yale and chief of obstetrics and gynecology at Yale New Haven Hospital, is now recognized as an international expert in endometriosis.
In an interview, he explains why the disease is so often misunderstood, how it affects the body, and what steps someone should take if they suspect they have it. The conversation has been edited for clarity and length.
Why Is Endometriosis So Misunderstood?
Taylor says societal discomfort with menstruation and menstrual pain has delayed conversations about the disease. “Many patients, families, and even some physicians avoid talking about menstrual pain. Pain with bowel movements or intercourse can feel deeply personal. This has slowed research and awareness.”
He notes that menstrual pain is often dismissed as normal. “When women describe severe pain, people say, ‘I have cramps too. Take some Motrin.’ Endometriosis pain is far worse, progressive, and can be debilitating. Pain is subjective, making it harder to recognize when it is abnormal.”
Why Does It Take So Long To Diagnose?
Taylor estimates that diagnosis can take five to 12 years. “Symptoms are often dismissed. For decades, surgery was the only way to confirm endometriosis, which delayed treatment. Today, we can diagnose it clinically with patient history, exams, and by ruling out other conditions. Surgery is no longer required for initial treatment.”
How Does Endometriosis Affect The Body?
Taylor emphasizes that endometriosis is a systemic, whole-body disease. “It can cause abdominal inflammation, intestinal irritation, bladder pain, and increased sensitivity to pain. Women often experience infertility, depression, anxiety, and lower body weight. Over time, it may raise the risk of heart disease and atherosclerosis.”
Current Treatments And New Research
Most treatments target hormones, since endometriosis depends on estrogen. Symptoms often appear after the first period and decrease at menopause. Progesterone or synthetic forms called progestins are commonly prescribed.
Drugs that lower estrogen, such as gonadotropin-releasing hormone (GnRH) agonists, have long been used. Newer GnRH antagonists reduce ovarian activity without completely shutting it down. Taylor led the study that helped bring the first oral GnRH antagonist to the U.S. in 2017.
His lab is also exploring immune-based therapies. “Endometriosis patients essentially experience internal bleeding each month, which inflames the body. Redirecting the immune system to clear abnormal tissue is a promising avenue.”
Advice For Those Who Suspect Endometriosis
Taylor encourages patients to speak up. “If you think you may have endometriosis, nine times out of 10, you probably do. Talk to your gynecologist. If needed, seek an endometriosis specialist who can diagnose the disease clinically and provide personalized treatment options.”
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