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Center for Treatment and Study of Endometriosis

Please choose one of the following options for more information:

If you have surgically diagnosed endometriosis, have painful periods, and pelvic pain, please contact us to find out if you are eligible for free treatment, study procedures, and visits.

Ozgul Muneyyirci-Delale, MD, Director
Telephone: 718-270-2101
E-mail: reproendo@downstate.edu

3 women

Message from the Director, Dr. Muneyyirci-Delale:

Welcome to the Center for Treatment and Study of Endometriosis web site!

I am currently the director of the Division of Reproductive Endocrinology and Infertility with a specialty in diagnosis and treatment of endometriosis. My interest in this topic, for both patient care and research, came from my interest in the manipulation of hormones. Specifically, endometriosis is a debilitating autoimmune disease that is dependent upon the hormone estrogen with no known cure. Patients with serious complications have been referred to me for almost 30 years such as those with advanced and non-operable stages of endometriosis, those who have undergone multiple surgeries but are still experiencing pain, and individuals that are in premature menopause; all of whom I have been able to help to manage and reduce the severity of their endometriosis. Preventing multiple surgeries, complications, and early menopause are the driving forces behind my research. We currently have funding, and are applying for more funding, to study the causes and factors of this disease in order to prevent it. We are currently looking at markers for endometriosis to diagnose and treat endometriosis in its early stages (during teenage years). We are also comparing different treatments for endometriosis. Just recently I have submitted a paper about women who have had recurrent endometriosis (endometriosis cysts) after surgeries. I have been able to shrink the size of the cyst and improve their symptoms.

Please look through our page on information about endometriosis, our staff, current studies we are conducting, and any other information. If you are interested in a consult, feel free to make an appointment.

Sincerely,
Dr. Muneyyirci-Delale (Dr. Muney)



Female Reproductive Organs

illustration of uterus

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).


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What is Endometriosis?

figure 1 figure 2 figure 3

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. A Combination of surgery and medical treatment.
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Research Activities

Endometriosis Treatment Study (NIH Sponsored)

Our study is comparing the effects of two well-established and FDA approved medications used for the treatment of endometriosis. These treatments are not experimental and have been on the market for over 20 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
  • Regular periods with no menopausal (change of life) symptoms
  • Surgically diagnosed with endometriosis

We are currently recruiting! If you have been diagnosed with endometriosis and interested in free treatment, please give us a call so that we can schedule a meeting or discuss the details further at 718-270-1364 or 718-270-2101. We can also be reached via e-mail at reproendo@downstate.edu.

We are also currently conducting studies on these additional topics:

  1. Endometriosis F11-R and other markers;
  2. Treatment and Study of Primary Dysmenorrhea (period cramps);
  3. Endometrium Urinary Steroids (hormones);
  4. Serum hormones and endometriosis;
  5. Fibroids/Leiomyomas;
  6. PCOS (Polycystic Ovarian Syndrome).
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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)

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Clinical Care

We can help!

We are also committed to helping women who have not been diagnosed with endometriosis but do experience painful period pains. Pelvic pain experienced around one's period or at other times of the month may be the first and most noticeable sign that something may be wrong. We encourage women to see a reproductive endocrinologist to further investigate the source their pelvic pain. To make an appointment to see Dr. Muneyyirci-Delale (Dr. Muney) independent of the research project, about infertility, endometriosis treatment options, or other gynecological issues, feel free to call us at (718) 270-2101.

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Additional Resources

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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

Mudar Dalloul, M.D.

Director, Labor & Delivery
Clinical Assistant Professor
Department of Obstetrics and Gynecology
SUNY Downstate Medical Center
Diplomate, American Board of Obstetrics and Gynecology

Vijaya L. Nacharaju, Ph.D.

Dr. Nacharaju has 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 has published over 40 research articles in peer reviewed journals. She 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.

Research Associates

Cassandra Charles

Ms. Charles obtained her B.A. in Public Health Studies from Johns Hopkins University. She was also recognized as a National Ventures Scholar. She has worked on various research projects with the departments of neurology and biostatistics at Johns Hopkins University as well as reproductive endocrinology at Weill Cornell Medical College. She is currently working in our department as a Research Associate since February 2009.

Jenny Anopa

Ms. Anopa received her M.A. in 2010 and B.A. in 2009 at Stony Brook University. She majored in psychology and graduated Summa Cum Laude. After working in several clinical laboratories focusing on love, aggression, and anxiety with Dr. Aron, Dr. O'Leary, and Dr. Hajcak, respectively, she is currently working in our department as a research associate since April 2010.

Other Personnel

Research Coordinator
Jessie Walsh

Research Pharmacist
Motria Mishko, R.Ph.

Laboratory Personnel
Lian-fu Yang, B.S.

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

Statistician
Jeremy Weedon, Ph.D.
Associate Director
Scientific Computing Center

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Selected Publications

  1. Muneyyirci-Delale O, Sinaii N, Charles C, Dalloul M, Osei-Tutu N, Stratton P: Changes in quality of life (QOL) in women with symptomatic endometriosis by pain type during treatment. Abstract submitted to the 66th Annual meeting of ASRM – October 2010 – In press
  2. Muneyyirci-Delale O, Sinaii N, Charles C, Dalloul M, Osei-Tutu N, Stratton P: Prevalence of metabolic syndrome and changes in lipid profiles of women with endometriosis during treatment. Abstract submitted to the 66th Annual meeting of ASRM – October 2010 – In press
  3. Muneyyirci-Delale O, Gupta A, Abraham C, Chandrareddy A, Cutler JB, Bowers CH: Management of dysfunctional uterine bleeding based on endometrial thickness. Intl J of Women's Health, in press.
  4. Muneyyirci-Delale O, Mathur D, Morkis M, Parris R, Cutler JB, Abulafia O: Medical Management of recurrent endometrioma with long term Norethindrone acetate. Intl J of Women's Health, in press.
  5. Muneyyirci-Delale O, Dalloul M, Charles C, Nacharaju V, Stratton P: F11R/JAM and SM Levels in Women with Endometriosis on Treatment with Lupron-depot vs. Norethindrone Acetate Presented at the Society of Gynecologic Investigation, 2010.
  6. Muneyyirci-Delale O, Osei-Tutu, N, Parris, R, Jiang, XC, Dalloul M, Nacharaju V, Fan YF, Cunningham A, Stratton P: Serum sphingomyelin and phosphatidylcholine in women with symptomatic endometriosis. Presented at the Soc Gyn Invest annual meeting, 2009.
  7. Muneyyiric-Delale O, Osei-Tutu N, Parris R, Chandrareddy A, Dalloul M, Nacharaju V, Feliz, A, Stratton P: Serum F11R/JAM-A levels in women with symptomatic endometriosis. Presented at the American Society for Reproductive Medicine 64th Annual Meeting, October 2008. Article »
  8. Cunningham A, Muneyyirci-Delale O: The association between primary dysmenorrheal and hypermesis gravidarum. Med Hypothese 2008; 73:90-91. Article »
  9. Muneyyirci-Delale O, Nacharaju VL, Kessel A, Yang L, Jalou S, Dalloul N, Rahman M, Bowers CH, Abulafia O: Type 2 11β-hydroxysteroid dehydrogenase activity in human fallopian tube and correlation of enzyme levels with endometrial histopathology. Am J of Reprod Immunol 54(2)96-100, 2005. Article »
  10. 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. Article »
  11. Muneyyirci-Delale O, Jalou S: Long-term treatment of symptomatic endometriosis with norethindrone acetate. Clin of Women's Health 1(2):69 2001.
  12. 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. Article »
  13. 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. Article »
  14. Muneyyirci-Delale O: Revival of norethindrone acetate (Aygestin). Endometriosis Association Newsletter, Vol 21, No 3, 2000.
  15. Endometriosis Association – Invited Presentation by Muneyyirci-Delale O: What is Aygestin and Can it Help with Endometriosis? October 21, 2000.
  16. 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. Article »
  17. Muneyyirci-Delale O, Jalou S: Long-term treatment of symptomatic endometriosis with norethindrone acetate. 55th Annual Meeting of the American Society of Reproductive Medicine, Toronto, Canada, September 1999.
  18. Muneyyirci-Delale O, Nezhat C, Martin D: Roundtable discussion entitled "Endometriosis: Diagnosis and Treatment." (The end product of the roundtable discussion was an eight-page educational supplement to Ob.Gyn News, May 1999. More than 35,000 copies were distributed to physicians and others).
  19. Muneyyirci-Delale O, Neil G, Maiman M, Serur E, Gordon D, Sedlis A: Endometriosis with massive ascites. Gynecologic Oncology 69:41-46, 1998 Article »
  20. 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) Article »

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Contact Us

Phone: (718) 270-2101 • (718) 270-1364
Fax: (718) 270- 2067
Email: reproendo@downstate.edu

Center for Treatment and Study of Endometriosis
OB/GYN Dept of Reproductive Endocrinology, B3- 492
450 Clarkson Ave
Brooklyn, NY 11203


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