Helping Women and Girls with Pelvic Pain and Endometriosis
Stacey Missmer is a professor of obstetrics, gynecology and reproductive biology in the Michigan State University College of Human Medicine. Her current research study, Women’s Outcomes Research and Knowledge, or WORK, is focused on diagnosing and treating pelvic pain in women and girls.
Missmer presented her research to the MSU Board of Trustees on June 18, 2021, and also developed the following Q&A with writers Geri Kelley and Emilie Lorditch from MSU Today.
Q: What inspired you to study women’s reproductive issues like endometriosis and pelvic pain?
A: Everyone I’ve ever spoken with about this work has themselves or has a loved one who has experienced pelvic pain or other life-impacting gynecologic health issues. For example, 1 in 3 women has experienced pelvic pain that impacts their work, school or home activities. There is never a shortage of questions to ask and answer. There is no doubt that discoveries that are small building blocks or huge leaps forward each have the potential to affect the health and well-being of individual women, their families and communities, and our society as a whole. The barriers remain and are frustrating, but the potential to make a better world for so many makes it easy to stay passionate.
Q: Tell us more about the WORK study?
A: The WORK study is unique, because it includes girls and young women, ages 12-30, from all over Michigan, ensuring inclusion of those with different backgrounds and experiencing different points along their health journey. Previous research around pelvic pain primarily studied women with the most resources and also insurance who were already successfully receiving care from a specialist. Our goal is to enroll a diverse group of girls and young women from all walks of life, including those in eastern and western cities and those living in rural areas in Michigan so that we can give voice to all, including those who do not have or have more limited access to health care.
Q: Why is this research important?
A: For so many reasons. People, including medical professionals, often don’t realize how many women are impacted by chronic pelvic pain — about 30%. Despite the large number affected, a lot about the condition remains unknown. Pelvic pain is often overlooked or incorrectly dismissed as “normal” period pain, but pain that disrupts your quality of life is not normal, even if it happens to coincide with your menstrual cycle.
Research has shown that it can take women with endometriosis, a disease where the endometrium-like tissue that normally lines the uterus grows outside the uterus and is often marked by pelvic pain, an average of seven years to receive a proper diagnosis and treatment, during which they interact with an average of five medical specialists. And that average only includes those who are successfully accessing care. Geography, income, insurance status, education and race are all demographic characteristics consistently associated with successful endometriosis diagnosis.
This delay and inadequate care can mean prolonged and worsening life-impacting pain and increased risk for more symptoms and conditions later in life. Women with endometriosis are at higher risk of developing depression and anxiety, heart disease, autoimmune disorders, infertility and ovarian cancer. We need data — documentation of the journeys of diverse women — to really understand who is experiencing pelvic pain and how it’s impacting their lives, with the goal of shortening the amount of time it takes for successful diagnosis and treatment.
Q: How has the COVID-19 pandemic had an impact on gynecological health?
A: During the pandemic, many women have experienced social isolation and economic stressors, increasing distress and possible use of unhealthy coping mechanisms. We know that chronic pelvic pain can increase in frequency and severity when women are challenged with stress, unraveling of personal coping mechanisms or diminished access to health care, creating a very real concern during an already difficult time.
Due to the inflammatory nature of chronic pelvic pain and endometriosis, the large number of women affected by these diseases may also be at a greater risk for SARS-CoV-2 infection, severity of COVID-19 and lower antibody response to infection or vaccination.
Some information used here was taken from a previous Ask the Expert with Missmer.
Learn more about the WORK study.