1 00:00:06,734 --> 00:00:07,735 >> I WANT TO THANK EVERYBODY WHO 2 00:00:07,735 --> 00:00:09,203 JOINED US THIS AFTERNOON AND 3 00:00:09,203 --> 00:00:11,172 HAVE OVER 800 REGISTRANTS AT OUR 4 00:00:11,172 --> 00:00:12,006 LAST COUNT. 5 00:00:12,006 --> 00:00:14,742 WE WANT TO MAKE SURE WE'RE USING 6 00:00:14,742 --> 00:00:16,811 USE OF OUR TIME AND SQUEEZING 7 00:00:16,811 --> 00:00:18,646 EVERY LAST SECOND OF OUR 8 00:00:18,646 --> 00:00:20,047 FANTASTIC SPEAKERS ON THE PANEL 9 00:00:20,047 --> 00:00:20,247 TODAY. 10 00:00:20,247 --> 00:00:23,050 I WANT TO START BY KICKING IT 11 00:00:23,050 --> 00:00:24,452 OVER TO THOSE IMPORTANT WOMEN 12 00:00:24,452 --> 00:00:29,423 GIVING OUR OPENING REMARKS, 13 00:00:29,423 --> 00:00:33,427 DR. JANINE CLAYTON FOLLOWED BY 14 00:00:33,427 --> 00:00:38,732 DR. BIANCHI FROM THE EUNICE 15 00:00:38,732 --> 00:00:39,567 KENNEDY SHRIVER CLINIC OF CHILD 16 00:00:39,567 --> 00:00:41,635 HEALTH AND HUMAN DEVELOPMENT. 17 00:00:41,635 --> 00:00:42,970 >> THANK YOU, DR. TINGEN AND 18 00:00:42,970 --> 00:00:44,839 THANK YOU FOR JOINING US TODAY 19 00:00:44,839 --> 00:00:48,042 FOR THE SECOND EVENT IN THE NIH 20 00:00:48,042 --> 00:00:48,943 WOMEN'S HEALTH ROUNDTABLE 21 00:00:48,943 --> 00:00:49,176 SERIES. 22 00:00:49,176 --> 00:00:53,314 I'M HONORED TO WELCOME YOU TO 23 00:00:53,314 --> 00:00:54,615 CHARTING NEW PATHS. 24 00:00:54,615 --> 00:00:57,318 THIS SERIES IS AN INTEGRAL PART 25 00:00:57,318 --> 00:00:58,652 OF THE WHITE HOUSE WOMEN'S 26 00:00:58,652 --> 00:01:00,921 HEALTH INITIATIVE WHICH AIMS TO 27 00:01:00,921 --> 00:01:01,856 ADDRESS CRITICAL ISSUES IN 28 00:01:01,856 --> 00:01:02,490 WOMEN'S HEALTH. 29 00:01:02,490 --> 00:01:04,358 TODAY WE'LL FOCUS ON THE 30 00:01:04,358 --> 00:01:08,562 IMPORTANT TOPIC OF END 31 00:01:08,562 --> 00:01:09,196 MEETRI 32 00:01:09,196 --> 00:01:09,497 MEETRIOSIS. 33 00:01:09,497 --> 00:01:10,865 IT'S A COMPLEX CONDITION THAT 34 00:01:10,865 --> 00:01:12,533 IMPACTS MILLIONS OF WOMEN 35 00:01:12,533 --> 00:01:16,504 LEADING TO SEVERE PAIN IN CASES 36 00:01:16,504 --> 00:01:18,839 INFERTILITY AND OTHER 37 00:01:18,839 --> 00:01:19,173 COMPLICATION. 38 00:01:19,173 --> 00:01:24,512 DESPITE THE WIDESPREAD EFFECT, 39 00:01:24,512 --> 00:01:25,613 ENDOMETRIOSIS REMAINS COMPLEX. 40 00:01:25,613 --> 00:01:26,714 THE DIVERSE SYMPTOMS AND COMPLEX 41 00:01:26,714 --> 00:01:28,582 UNDERLYING MECHANISMS OF THE 42 00:01:28,582 --> 00:01:30,317 DISEASE UNDER SCORE THE URGENT 43 00:01:30,317 --> 00:01:31,752 NEED FOR COMPREHENSIVE RESEARCH 44 00:01:31,752 --> 00:01:33,454 AND SUPPORT TO ADDRESS OUR GAPS 45 00:01:33,454 --> 00:01:35,222 IN KNOWLEDGE. 46 00:01:35,222 --> 00:01:37,258 FILLING THESE GAPS IS ESSENTIAL 47 00:01:37,258 --> 00:01:38,893 FOR ENHANCING OUR UNDERSTANDING 48 00:01:38,893 --> 00:01:41,428 AND IMPROVING CARE FOR THOSE 49 00:01:41,428 --> 00:01:42,530 AFFECTED BY THIS CONDITION. 50 00:01:42,530 --> 00:01:44,632 AND THIS ROUNDTABLE WAS 51 00:01:44,632 --> 00:01:46,300 DEVELOPED IN RESPONSE TO 52 00:01:46,300 --> 00:01:47,301 PRESIDENTIAL MEMORANDUM ISSUED 53 00:01:47,301 --> 00:01:49,370 BY THE WHITE HOUSE ON NOVEMBER 54 00:01:49,370 --> 00:01:51,505 13, 2023 WHICH LAUNCHED THE 55 00:01:51,505 --> 00:01:52,106 FIRST EVER WHITE HOUSE 56 00:01:52,106 --> 00:01:52,706 INITIATIVE ON WOMEN'S HEALTH 57 00:01:52,706 --> 00:01:55,676 RESEARCH. 58 00:01:55,676 --> 00:01:57,278 THIS INITIATIVE IS SPECIFICALLY 59 00:01:57,278 --> 00:01:58,712 DESIGN TO INTRODUCE 60 00:01:58,712 --> 00:01:59,747 INTERDISCIPLINARY WOMEN'S HEALTH 61 00:01:59,747 --> 00:02:00,247 RESEARCH. 62 00:02:00,247 --> 00:02:02,216 IN ADDITION, PRESIDENT BIDEN 63 00:02:02,216 --> 00:02:05,920 SIGNED EXECUTIVE ORDER 14120 ON 64 00:02:05,920 --> 00:02:07,421 ADVANCING WOMEN'S HEALTH 65 00:02:07,421 --> 00:02:08,956 RESEARCH AND INNOVATION 66 00:02:08,956 --> 00:02:10,858 MANDATING WOMEN'S HEALTH REMAIN 67 00:02:10,858 --> 00:02:12,526 A CENTRAL FOCUS ACROSS THE 68 00:02:12,526 --> 00:02:14,762 FEDERAL RESEARCH AGENDA AND 69 00:02:14,762 --> 00:02:14,995 BUDGET. 70 00:02:14,995 --> 00:02:16,397 AND TODAY'S EVENT EXEMPLIFIES 71 00:02:16,397 --> 00:02:19,800 OUR COMMITMENT TO THAT GOAL. 72 00:02:19,800 --> 00:02:23,704 THE GOAL IS TO BRING 73 00:02:23,704 --> 00:02:24,838 ENDOMETRIOSIS TO THE FOREFRONT 74 00:02:24,838 --> 00:02:26,607 AND DRIVE INNOVATIVE RESEARCH 75 00:02:26,607 --> 00:02:28,709 AND DRIVE PATIENT CARE. 76 00:02:28,709 --> 00:02:31,946 I AM DELIGHTED THIS EVENT IS 77 00:02:31,946 --> 00:02:34,215 CO-HOSTED BY THE NIH OFFICE ON 78 00:02:34,215 --> 00:02:35,783 WOMEN'S HEALTH AND THE EUNICE 79 00:02:35,783 --> 00:02:36,417 KENNEDY SHRIVER INSTITUTE OF 80 00:02:36,417 --> 00:02:38,252 CHILD HEALTH AND HUMAN 81 00:02:38,252 --> 00:02:38,619 DEVELOPMENT. 82 00:02:38,619 --> 00:02:40,955 THIS JOINT EFFORT IS EMBLEMATIC 83 00:02:40,955 --> 00:02:42,489 OF OUR NIH WIDE DEDICATION TO 84 00:02:42,489 --> 00:02:43,023 ADVANCING WOMEN'S HEALTH 85 00:02:43,023 --> 00:02:45,259 RESEARCH. 86 00:02:45,259 --> 00:02:49,296 TOGETHER WE HAVE ASSEMBLED A 87 00:02:49,296 --> 00:02:52,266 DIVERSE GROUP OF KEY INTERESTED 88 00:02:52,266 --> 00:02:53,100 PERSONS INCLUDING RESEARCHERS 89 00:02:53,100 --> 00:02:53,801 AND INTERESTED PERSONS AND 90 00:02:53,801 --> 00:02:54,668 COMMUNITY MEMBERS TO SHARE 91 00:02:54,668 --> 00:02:57,304 INSIGHT AND EXPERIENCES. 92 00:02:57,304 --> 00:02:59,473 AS WE ADDRESS TODAY'S TOPIC WE 93 00:02:59,473 --> 00:03:00,741 LOOK FORWARD TO PARTNERING WITH 94 00:03:00,741 --> 00:03:03,611 OTHER INSTITUTES AND COLLEAGUES 95 00:03:03,611 --> 00:03:04,445 IN TACKLING ADDITIONAL ISSUES IN 96 00:03:04,445 --> 00:03:05,179 THE FUTURE CRUCIAL TO THE HEALTH 97 00:03:05,179 --> 00:03:05,679 OF WOMEN. 98 00:03:05,679 --> 00:03:10,484 I WOULD LIKE TO TAKE A MOMENT TO 99 00:03:10,484 --> 00:03:15,956 ACKNOWLEDGE DR. DIANA BIANCHI 100 00:03:15,956 --> 00:03:18,492 SHE'S BEEN INSTRUMENTAL IN 101 00:03:18,492 --> 00:03:20,928 BRINGING THIS EVENT TO FRUITION. 102 00:03:20,928 --> 00:03:22,429 HER DEDICATION TO IMPROVING THE 103 00:03:22,429 --> 00:03:23,564 LIVES OF WOMEN AND CHILDREN IS 104 00:03:23,564 --> 00:03:24,632 TRULY INSPIRING AND WE'RE 105 00:03:24,632 --> 00:03:25,933 FORTUNATE TO HAVE HER AS A 106 00:03:25,933 --> 00:03:27,601 DRIVING FORCE IN THIS 107 00:03:27,601 --> 00:03:29,937 INITIATIVE. 108 00:03:29,937 --> 00:03:32,006 TODAY WE'RE HERE TO LISTEN, 109 00:03:32,006 --> 00:03:32,806 LEARN AND COLLABORATE. 110 00:03:32,806 --> 00:03:36,744 WE'LL EXPLORE THE LATEST 111 00:03:36,744 --> 00:03:37,344 DEVELOPMENT IN ENDOMETRIOSIS 112 00:03:37,344 --> 00:03:38,412 RESEARCH AND DIAGNOSIS AND 113 00:03:38,412 --> 00:03:38,812 TREATMENT. 114 00:03:38,812 --> 00:03:40,581 THIS ROUNDTABLE WILL FOCUS ON 115 00:03:40,581 --> 00:03:44,485 THE CHALLENGES THAT PATIENTS AND 116 00:03:44,485 --> 00:03:46,920 HEALTH CARE PROVIDERS FACE AND 117 00:03:46,920 --> 00:03:49,390 SEEK STRATEGY TO OVERCOME THESE 118 00:03:49,390 --> 00:03:49,623 HURDLES. 119 00:03:49,623 --> 00:03:51,225 IMPORTANTLY WE'LL ALSO NEED TO 120 00:03:51,225 --> 00:03:53,961 AMPLIFY THE VOICES OF WOMEN 121 00:03:53,961 --> 00:03:55,696 AFFECTED BY ENDOMETRIOSIS AND 122 00:03:55,696 --> 00:03:57,431 CONSIDER THE HEALTH DISPARITIES 123 00:03:57,431 --> 00:03:59,833 THAT AFFECT THEIR CARE. 124 00:03:59,833 --> 00:04:02,836 THE ORWH UNDER STUDIED, UNDER 125 00:04:02,836 --> 00:04:05,105 REPORTED AND UNDER REPRESENTED 126 00:04:05,105 --> 00:04:07,274 U-3 SUPPLEMENT PROGRAM IS ALSO 127 00:04:07,274 --> 00:04:08,208 SUPPORTING SEVERAL INNOVATIVE 128 00:04:08,208 --> 00:04:11,045 PROJECTS AIMED AT ADVANCING OUR 129 00:04:11,045 --> 00:04:12,046 UNDERSTANDING OF ENDOMETRIOSIS 130 00:04:12,046 --> 00:04:14,081 WHICH UNDER SCORES OUR 131 00:04:14,081 --> 00:04:15,883 COMMITMENT AGAIN TO ADDRESSING 132 00:04:15,883 --> 00:04:16,383 THESE COMPLEX ISSUES. 133 00:04:16,383 --> 00:04:18,419 BY ACKNOWLEDGING AND ADDRESSING 134 00:04:18,419 --> 00:04:20,054 THESE DISPARITIES WE CAN WORK 135 00:04:20,054 --> 00:04:21,722 TOWARDS MORE EFFECTIVE SOLUTIONS 136 00:04:21,722 --> 00:04:23,590 AND MAKE SURE THEY REACH 137 00:04:23,590 --> 00:04:24,124 EVERYONE. 138 00:04:24,124 --> 00:04:26,660 WE HOPE TODAY'S DISCUSSIONS WILL 139 00:04:26,660 --> 00:04:29,763 HELP SHAPE THE FUTURE OF 140 00:04:29,763 --> 00:04:34,068 ENDOMETRIOSIS RESEARCH AND CARE, 141 00:04:34,068 --> 00:04:36,537 ENSURING WE MOVE TO A DEEPER 142 00:04:36,537 --> 00:04:37,404 UNDERSTANDING OF THIS CONDITION. 143 00:04:37,404 --> 00:04:40,274 I WANT TO EXTEND A HEARTFELT 144 00:04:40,274 --> 00:04:43,577 THANKS TO OUR ESTEEMED PANELISTS 145 00:04:43,577 --> 00:04:44,578 AND PARTICIPANTS AND THOSE 146 00:04:44,578 --> 00:04:46,447 BEHIND THE SCENES FOR THEIR 147 00:04:46,447 --> 00:04:46,780 CONTRIBUTIONS. 148 00:04:46,780 --> 00:04:48,215 YOUR EXPERTISE AND COMMITMENT 149 00:04:48,215 --> 00:04:50,484 ARE INVALUABLE AS WE WORK 150 00:04:50,484 --> 00:04:52,953 TOGETHER TO IMPROVE THE LIVES OF 151 00:04:52,953 --> 00:04:55,356 THOSE AFFECTED BY ENDOMETRIOSIS. 152 00:04:55,356 --> 00:04:56,457 IN CLOSING I ENCOURAGE EVERYONE 153 00:04:56,457 --> 00:04:59,526 TO ENGAGE FULLY IN TODAY'S 154 00:04:59,526 --> 00:05:01,428 DISCUSSION, SHARE YOUR 155 00:05:01,428 --> 00:05:03,430 KNOWLEDGE, ASK QUESTIONS AND 156 00:05:03,430 --> 00:05:05,366 CHALLENGE ASSUMPTIONS. 157 00:05:05,366 --> 00:05:07,034 LET'S USE THIS OPPORTUNITY TO 158 00:05:07,034 --> 00:05:08,502 PUT SCIENCE TO WORK FOR THE 159 00:05:08,502 --> 00:05:09,436 HEALTH OF WOMEN. 160 00:05:09,436 --> 00:05:10,671 THANK YOU ONCE AGAIN FOR BEING 161 00:05:10,671 --> 00:05:13,173 HERE TODAY AND I LOOK FORWARD TO 162 00:05:13,173 --> 00:05:15,609 A PRODUCTIVE AND INSPIRING 163 00:05:15,609 --> 00:05:21,081 ROUNDTABLE. 164 00:05:21,081 --> 00:05:22,616 BACK TO YOU, DR. TINGEN. 165 00:05:22,616 --> 00:05:24,151 >> THANK YOU FOR HIGHLIGHTING 166 00:05:24,151 --> 00:05:25,786 THE TRANS NIH NATURE OF THE TALK 167 00:05:25,786 --> 00:05:26,887 AS IT'S COLLABORATIVE AND WE'RE 168 00:05:26,887 --> 00:05:29,423 EXCITED TO WORK TOGETHER ON THE 169 00:05:29,423 --> 00:05:30,724 IMPORTANT TOPIC. 170 00:05:30,724 --> 00:05:32,626 DR. BIANCHI, I'LL TURN IT OVER 171 00:05:32,626 --> 00:05:35,763 TO YOU FOR YOUR OPENING REMARKS. 172 00:05:35,763 --> 00:05:36,630 >> THANK YOU, DR. TINGEN. 173 00:05:36,630 --> 00:05:38,365 GOOD AFTERNOON, EVERYONE. 174 00:05:38,365 --> 00:05:40,834 ON BEHALF OF NICHD WE'RE 175 00:05:40,834 --> 00:05:46,340 THRILLED TO BE HERE AND TO BE 176 00:05:46,340 --> 00:05:49,243 CO-HOST 177 00:05:49,243 --> 00:05:50,944 CO-HOSTING THIS PROGRAM. 178 00:05:50,944 --> 00:05:53,180 I'M THE DIRECTOR OF THE EUNICE 179 00:05:53,180 --> 00:05:53,747 KENNEDY SHRIVER NATIONAL 180 00:05:53,747 --> 00:05:57,084 INSTITUTE OF CHILD HEALTH AND 181 00:05:57,084 --> 00:05:59,787 HUMAN DEVELOPMENT, ALSO KNOWN AS 182 00:05:59,787 --> 00:06:02,022 NICHD AND WE HAVE QUITE A BIG 183 00:06:02,022 --> 00:06:03,624 PORTFOLIO IN WOMEN'S GYNECOLOGIC 184 00:06:03,624 --> 00:06:06,593 HEALTH IN PARTICULAR. 185 00:06:06,593 --> 00:06:08,529 NICHD'S MISSION IS TO LEAD 186 00:06:08,529 --> 00:06:10,330 RESEARCH AND TRAINING TO 187 00:06:10,330 --> 00:06:13,801 UNDERSTAND HUMAN DEVELOPMENT, 188 00:06:13,801 --> 00:06:14,835 IMPROVE REPRODUCTIVE HEALTH, 189 00:06:14,835 --> 00:06:15,669 ENHANCE THE LIVES OF CHILDREN 190 00:06:15,669 --> 00:06:17,504 AND ADOLESCENTS AND OPTIMIZE 191 00:06:17,504 --> 00:06:26,613 ABILITIES FOR ALL. 192 00:06:26,613 --> 00:06:30,384 ENDOMETRIOSIS AFFECTS 10% OF 193 00:06:30,384 --> 00:06:32,653 WOMEN WORLDWIDE AND 194 00:06:32,653 --> 00:06:34,188 ENDOMETRIOSIS ALSO INCREASES THE 195 00:06:34,188 --> 00:06:36,657 RISK OF OVARIAN CANCER, 196 00:06:36,657 --> 00:06:41,428 DEPRESSION, MIGRAINES, LUPUS, 197 00:06:41,428 --> 00:06:43,597 MULTIPLE SCLEROSIS AND PAIN AND 198 00:06:43,597 --> 00:06:45,699 AUTO IMMUNE DISEASES. 199 00:06:45,699 --> 00:06:49,603 FINDING BETTER WAYS TO 200 00:06:49,603 --> 00:06:54,041 DEFINITIVELY DIAGNOSIS AND TREAT 201 00:06:54,041 --> 00:06:56,176 ENDOMETRIOSIS IS CRUCIAL TO 202 00:06:56,176 --> 00:07:00,514 IMPROVING WOMEN LIVES. 203 00:07:00,514 --> 00:07:05,152 THE AVERAGE TIME TO DIAGNOSIS 204 00:07:05,152 --> 00:07:07,654 ENDOMETRIOSIS 10 YEARS AND THE 205 00:07:07,654 --> 00:07:11,258 ONLY CURRENT METHODS ARE 206 00:07:11,258 --> 00:07:11,825 INVASIVE. 207 00:07:11,825 --> 00:07:13,360 WE SUPPORT A PORTION OF 208 00:07:13,360 --> 00:07:15,629 ENDOMETRIOSIS RESEARCH AND ONE 209 00:07:15,629 --> 00:07:21,401 OF THE ASPIRATIONAL GOALS IN OUR 210 00:07:21,401 --> 00:07:23,537 2019 STRATEGIC PLAN WAS TO FIND 211 00:07:23,537 --> 00:07:25,973 NEW WAYS TO DIAGNOSIS AND 212 00:07:25,973 --> 00:07:27,975 PREVENT AND TREAT ENDOMETRIOSIS. 213 00:07:27,975 --> 00:07:30,944 SO WE HAVE BEEN VERY COMMITTED 214 00:07:30,944 --> 00:07:33,914 FOR A LONG TIME WITH REGARD TO 215 00:07:33,914 --> 00:07:34,615 THIS PARTICULAR CONDITION. 216 00:07:34,615 --> 00:07:36,683 AND TO THAT END AND HERE WE HAVE 217 00:07:36,683 --> 00:07:39,086 THE IMPORTANT SLIDE I WANT YOU 218 00:07:39,086 --> 00:07:41,989 TO LOOK AT, LAST WEEK NICHD 219 00:07:41,989 --> 00:07:43,857 ALONG WITH THE NATIONAL 220 00:07:43,857 --> 00:07:46,193 INSTITUTE OF BIO MEDICAL IMAGING 221 00:07:46,193 --> 00:07:47,427 AND BIO ENGINEERING OTHERWISE 222 00:07:47,427 --> 00:07:51,598 KNOWN AS NIBIB LAUNCHED THE 223 00:07:51,598 --> 00:07:55,002 RAPID ACCELERATION OF DIAGNOSTIC 224 00:07:55,002 --> 00:07:56,737 TECHNOLOGIES FOR RADX TECH 225 00:07:56,737 --> 00:08:01,141 ADVANCING CURES AND THERAPIES 226 00:08:01,141 --> 00:08:01,675 AND ENDING ENDOMETRIOSIS 227 00:08:01,675 --> 00:08:05,312 DIAGNOSTIC DELAYS KNOWN AS THE 228 00:08:05,312 --> 00:08:09,216 ACT ENDO CHALLENGE. 229 00:08:09,216 --> 00:08:12,286 IT WILL AWARD $3 MILLION IN 230 00:08:12,286 --> 00:08:15,455 PRIZES TO ACCELERATE THE 231 00:08:15,455 --> 00:08:17,591 DEVELOPMENT OF INNOVATIVE 232 00:08:17,591 --> 00:08:19,593 TECHNOLOGIES FOR THE DIAGNOSIS 233 00:08:19,593 --> 00:08:20,761 OF ENDOMETRIOSIS. 234 00:08:20,761 --> 00:08:22,729 WE ARE SEEKING TEAMS AND 235 00:08:22,729 --> 00:08:24,097 HOPEFULLY SOME OF YOU ARE 236 00:08:24,097 --> 00:08:26,099 LISTENING OUT THERE, WITH IDEAS 237 00:08:26,099 --> 00:08:32,439 TO SHORTEN THE TIME TO 238 00:08:32,439 --> 00:08:33,473 DIAGNOSIS, ELIMINATE THE 239 00:08:33,473 --> 00:08:36,510 INVASIVENESS OF CURRENT 240 00:08:36,510 --> 00:08:37,844 TECHNIQUES IMPROVE 241 00:08:37,844 --> 00:08:38,378 ACCESSIBILITY, SAFETY, 242 00:08:38,378 --> 00:08:40,280 CONVENIENCE AND REDUCING THE 243 00:08:40,280 --> 00:08:41,415 COST OF DIAGNOSIS. 244 00:08:41,415 --> 00:08:45,419 INNOVATIVE APPROACHES MAY 245 00:08:45,419 --> 00:08:46,987 INCLUDE IMAGING TECHNOLOGIES, IN 246 00:08:46,987 --> 00:08:49,356 VITRO DIAGNOSTIC DEVICES, 247 00:08:49,356 --> 00:08:53,026 CLINICAL LABORATORY TESTS, 248 00:08:53,026 --> 00:08:55,662 WEARABLE DEVICES, SMARTPHONE 249 00:08:55,662 --> 00:08:57,431 ENABLED DIAGNOSTIC TOOLS, 250 00:08:57,431 --> 00:08:59,032 INTEGRATED SENSING TECHNOLOGIES 251 00:08:59,032 --> 00:09:02,402 AND DIGITAL HEALTH PLATFORMS. 252 00:09:02,402 --> 00:09:05,405 THIS TWO-YEAR CHALLENGE WILL 253 00:09:05,405 --> 00:09:07,608 CONSISTENT OF THREE PHASES. 254 00:09:07,608 --> 00:09:10,210 SUBMISSIONS TO PHASE 1 ARE GOING 255 00:09:10,210 --> 00:09:12,980 TO BE DUE OCTOBER 11, 2024 AND 256 00:09:12,980 --> 00:09:15,616 THE FINAL WINNERS ARE EXPECTED 257 00:09:15,616 --> 00:09:17,417 TO BE ANNOUNCED IN MARCH OF 258 00:09:17,417 --> 00:09:19,052 2026. 259 00:09:19,052 --> 00:09:20,220 THE GOAL OF THIS CHALLENGE IS TO 260 00:09:20,220 --> 00:09:25,292 MAKE A MEANINGFUL IMPACT ON THE 261 00:09:25,292 --> 00:09:26,793 MILLIONS OF REPRODUCTIVE AGED 262 00:09:26,793 --> 00:09:28,595 WOMEN AND GIRLS AFFECTED BY 263 00:09:28,595 --> 00:09:28,929 ENDOMETRIOSIS. 264 00:09:28,929 --> 00:09:30,964 I'D LIKE IT THANK ALL THE PEOPLE 265 00:09:30,964 --> 00:09:34,735 WHO HAVE BEEN INVOLVED IN 266 00:09:34,735 --> 00:09:36,203 ORGANIZING THIS PARTICULAR 267 00:09:36,203 --> 00:09:39,239 PROGRAM AS WELL AS OUR SPEAKERS, 268 00:09:39,239 --> 00:09:42,576 PEOPLE LISTENING, PEOPLE ENGAGED 269 00:09:42,576 --> 00:09:44,077 AND WILL BE ASKING QUESTIONS, 270 00:09:44,077 --> 00:09:45,579 THE PEOPLE BEHIND THE SCENES WHO 271 00:09:45,579 --> 00:09:48,048 ARE PUTTING TOGETHER THE 272 00:09:48,048 --> 00:09:51,418 AUDIO/VISUAL ASPECTS OF THE 273 00:09:51,418 --> 00:09:53,553 PROGRAM AND OF COURSE STAFFS OF 274 00:09:53,553 --> 00:09:57,024 BOTH THE ORWH AND NICHD AND ANY 275 00:09:57,024 --> 00:09:57,624 OTHER INSTITUTES OR CENTERS 276 00:09:57,624 --> 00:09:59,493 INVOLVED IN THE PROGRAM. 277 00:09:59,493 --> 00:10:02,396 SO WITH THAT, I'D LIKE TO TURN 278 00:10:02,396 --> 00:10:04,297 THE ROUNDTABLE OVER TO 279 00:10:04,297 --> 00:10:09,102 DR. CANDACE TINGEN THE CHIEF OF 280 00:10:09,102 --> 00:10:10,771 NICHD'S GYNECOLOGIC HEALTH AND 281 00:10:10,771 --> 00:10:13,440 DISEASE BRANCH. 282 00:10:13,440 --> 00:10:14,908 CANDACE. 283 00:10:14,908 --> 00:10:15,676 >> THANK YOU VERY MUCH, 284 00:10:15,676 --> 00:10:16,443 DR. BIANCHI. 285 00:10:16,443 --> 00:10:17,911 TO THE AUDIENCE I WANT TO SAY 286 00:10:17,911 --> 00:10:19,346 THE SET OF ROUNDTABLES AS 287 00:10:19,346 --> 00:10:21,281 DR. CLAYTON MENTIONED IS THE WAY 288 00:10:21,281 --> 00:10:23,550 NIH GETS BACK IN TOUCH WITH OUR 289 00:10:23,550 --> 00:10:24,951 COMMUNITY AND LET'S YOU KNOW THE 290 00:10:24,951 --> 00:10:27,521 RESEARCH AND SCIENCE AND 291 00:10:27,521 --> 00:10:28,789 CLINICAL WORK THAT WE ARE DOING 292 00:10:28,789 --> 00:10:31,758 ON BEHALF OF THE AMERICAN 293 00:10:31,758 --> 00:10:32,025 PUBLIC. 294 00:10:32,025 --> 00:10:34,561 AND SO IN HOPES OF BRINGING 295 00:10:34,561 --> 00:10:36,096 THESE PANEL OF AMAZING 296 00:10:36,096 --> 00:10:39,066 CLINICIANS AND PATIENT ADVOCATES 297 00:10:39,066 --> 00:10:40,133 AND SCIENTISTS CLOSER TO YOU, 298 00:10:40,133 --> 00:10:42,936 I'VE ASKED THEM TO INTRODUCE 299 00:10:42,936 --> 00:10:44,171 THEMSELVES IN A SLIGHTLY MORE 300 00:10:44,171 --> 00:10:46,873 IMPERSONAL MANNER SO WE CAN FEEL 301 00:10:46,873 --> 00:10:48,575 WE'RE ALL TOGETHER IN THE ROOM. 302 00:10:48,575 --> 00:10:51,411 I'LL ASK MY SPEAKERS JUST TO 303 00:10:51,411 --> 00:10:56,583 COME ON CAMERA AND VERY BRIEFLY 304 00:10:56,583 --> 00:10:57,584 EXPLAIN YOUR CONNECTION TO 305 00:10:57,584 --> 00:10:58,318 ENDOMETRIOSIS AND WHY YOU'RE 306 00:10:58,318 --> 00:10:59,586 HERE TODAY AND THEN GIVE YOU THE 307 00:10:59,586 --> 00:11:01,488 TIME FOR TALKS TO HEAR FROM EACH 308 00:11:01,488 --> 00:11:02,122 OF YOU. 309 00:11:02,122 --> 00:11:04,091 I'LL START WITH DIANA. 310 00:11:04,091 --> 00:11:04,858 >> HELLO. 311 00:11:04,858 --> 00:11:05,892 THANK YOU FOR HAVING ME. 312 00:11:05,892 --> 00:11:07,828 IT'S GREAT TO BE HERE. 313 00:11:07,828 --> 00:11:11,064 I'M DIANA FALZONE ABLE 314 00:11:11,064 --> 00:11:13,400 AMBASSADOR FOR THE ENDOMETRIOSIS 315 00:11:13,400 --> 00:11:18,772 FOUNDATION OF AMERICA, HOST AND 316 00:11:18,772 --> 00:11:22,375 PRODUCER OF ENDO TV AND 317 00:11:22,375 --> 00:11:23,977 JOURNALIST AND LIVE WITH 318 00:11:23,977 --> 00:11:24,311 ENDOMETRIOSIS. 319 00:11:24,311 --> 00:11:25,612 >> THANK YOU. 320 00:11:25,612 --> 00:11:26,012 STACY. 321 00:11:26,012 --> 00:11:29,082 >> I'M A PROFESSOR AT UNIVERSITY 322 00:11:29,082 --> 00:11:33,253 OF MICHIGAN AND REPRODUCTIVE 323 00:11:33,253 --> 00:11:33,787 EPIDEMIOLOGIST STUDYING 324 00:11:33,787 --> 00:11:35,689 ENDOMETRIOSIS ALMOST 30 YEARS 325 00:11:35,689 --> 00:11:39,392 NOW FOCUSSING ON LONGITUDINAL 326 00:11:39,392 --> 00:11:41,428 DISCOVERIES AND THE AFFECTS OF 327 00:11:41,428 --> 00:11:45,432 ENDOMETRIOSIS ACROSS A WOMAN'S 328 00:11:45,432 --> 00:11:51,671 LIFE COURSE. 329 00:11:51,671 --> 00:12:02,382 >> I'M SUSIE ASSINE AND CARING 330 00:12:02,983 --> 00:12:04,317 FOR PATIENTS WITH CHRONIC PELVIC 331 00:12:04,317 --> 00:12:07,287 PAIN AND ENDOMETRIOSIS AND 332 00:12:07,287 --> 00:12:08,989 SHIFTED INTO CLINICAL RESEARCH 333 00:12:08,989 --> 00:12:11,158 EARLY IN THE COURSE TO TRY TO 334 00:12:11,158 --> 00:12:13,460 HELP US BETTER UNDERSTAND WHY IS 335 00:12:13,460 --> 00:12:16,496 IT THAT WOMEN WITH ENDOMETRIOSIS 336 00:12:16,496 --> 00:12:17,864 SUFFER FROM PAIN AND BETTER 337 00:12:17,864 --> 00:12:18,932 STRATEGIES TO TRY TO HELP THEM 338 00:12:18,932 --> 00:12:22,702 GET A BETTER QUALITY OF LIFE. 339 00:12:22,702 --> 00:12:24,571 >> FANTASTIC. 340 00:12:24,571 --> 00:12:24,838 THANK YOU. 341 00:12:24,838 --> 00:12:26,173 AND RIDHI. 342 00:12:26,173 --> 00:12:29,709 >> I'M CO-FOUNDER AND CEO OF 343 00:12:29,709 --> 00:12:30,510 NEXT GEN JANE. 344 00:12:30,510 --> 00:12:35,582 WE'RE A START-UP BUILDING 345 00:12:35,582 --> 00:12:37,350 NON-INVASIVE MENSTRUAL 346 00:12:37,350 --> 00:12:37,651 DIAGNOSTICS. 347 00:12:37,651 --> 00:12:38,885 ONE OF THE FIRST CONDITIONS 348 00:12:38,885 --> 00:12:39,653 WE'RE LOOKING AT IS 349 00:12:39,653 --> 00:12:40,554 ENDOMETRIOSIS AND HAVE BEEN 350 00:12:40,554 --> 00:12:45,458 WORKING ON IT CLOSE TO A DECADE. 351 00:12:45,458 --> 00:12:49,629 PLEASURE TO BE HERE. 352 00:12:49,629 --> 00:12:51,665 >> I HOPE EVERYONE IN THE 353 00:12:51,665 --> 00:12:53,300 AUDIENCE IS EXCITED TO HEAR WHAT 354 00:12:53,300 --> 00:12:55,936 THESE FANTASTIC WOMEN HAVE TO 355 00:12:55,936 --> 00:12:57,337 SAY ABOUT ENDOMETRIOSIS. 356 00:12:57,337 --> 00:12:58,872 WE'LL GIVE THEM EACH 10 MINUTES 357 00:12:58,872 --> 00:13:00,874 TO PRESENT AND A SHORT TWO TO 358 00:13:00,874 --> 00:13:02,309 THREE MINUTES FOR POIGNANT 359 00:13:02,309 --> 00:13:04,344 QUESTIONS AFTER THE 360 00:13:04,344 --> 00:13:05,712 PRESENTATIONS AND AFTER ALL THE 361 00:13:05,712 --> 00:13:07,814 SPEAKERS HAVE GONE WE'LL HAVE A 362 00:13:07,814 --> 00:13:08,315 ROUNDTABLE DISCUSSION. 363 00:13:08,315 --> 00:13:09,649 WE WILL VERY MUCH HOPE TO BE 364 00:13:09,649 --> 00:13:11,151 SEEING ALL THE QUESTIONS FROM 365 00:13:11,151 --> 00:13:12,185 OUR AUDIENCE AND BE ABLE TO 366 00:13:12,185 --> 00:13:14,554 BRING YOUR QUESTIONS FORWARD TO 367 00:13:14,554 --> 00:13:15,822 THESE AMAZING SPEAKERS. 368 00:13:15,822 --> 00:13:18,458 SO THAT WILL BE MY GOAL LATER ON 369 00:13:18,458 --> 00:13:19,793 SO PLEASE AS YOU ARE LISTENING 370 00:13:19,793 --> 00:13:23,830 TO TALKS FEEL FREE TO PUT YOUR 371 00:13:23,830 --> 00:13:24,564 QUESTIONS IN THE CHAT IN THE 372 00:13:24,564 --> 00:13:24,731 Q&A. 373 00:13:24,731 --> 00:13:28,635 I WILL START WITH OUR FIRST 374 00:13:28,635 --> 00:13:32,038 SPEAKER, MANY OF YOU IN OUR 375 00:13:32,038 --> 00:13:33,340 AUDIENCE AND COMMUNITY ARE 376 00:13:33,340 --> 00:13:34,107 PATIENTS WITH ENDOMETRIOSIS AND 377 00:13:34,107 --> 00:13:34,908 HAVE A LIVED EXPERIENCE WITH 378 00:13:34,908 --> 00:13:35,375 THIS CONDITION. 379 00:13:35,375 --> 00:13:39,679 WE WANTED TOE MAKE SURE THAT WE 380 00:13:39,679 --> 00:13:42,215 KICK OFF THE DISCUSSION WITH AN 381 00:13:42,215 --> 00:13:43,450 UNDERSTANDING THAT'S WHAT 382 00:13:43,450 --> 00:13:44,918 UNDERSTANDS ALL OF US. 383 00:13:44,918 --> 00:13:46,219 THAT'S WHAT BRINGS EVERY 384 00:13:46,219 --> 00:13:47,320 CLINICIAN AND SCIENTIST AND 385 00:13:47,320 --> 00:13:48,655 EVERYONE AT NIH TOGETHER ON THE 386 00:13:48,655 --> 00:13:49,956 TOPIC IS THE UNDERSTANDING OF 387 00:13:49,956 --> 00:13:51,157 THIS LIVED EXPERIENCE AND HOW WE 388 00:13:51,157 --> 00:13:53,927 WANT TO IMPROVE THAT FOR THE 389 00:13:53,927 --> 00:13:54,394 AMERICAN PUBLIC. 390 00:13:54,394 --> 00:13:59,165 SO STARTING OFF WE WILL HEAR 391 00:13:59,165 --> 00:14:02,302 FROM DIANA FALZONE AS YOU HEARD 392 00:14:02,302 --> 00:14:05,639 IS A JOURNALIST IN REAL LIFE AND 393 00:14:05,639 --> 00:14:07,440 JOINS US AS THE ENDOMETRIOSIS 394 00:14:07,440 --> 00:14:08,909 FOUNDATION OF AMERICA 395 00:14:08,909 --> 00:14:09,209 AMBASSADOR. 396 00:14:09,209 --> 00:14:10,977 >> THANK YOU. 397 00:14:10,977 --> 00:14:12,245 GOOD AFTERNOON. 398 00:14:12,245 --> 00:14:14,581 THANK YOU TO THE NIH, THE WHITE 399 00:14:14,581 --> 00:14:16,249 HOUSE WOMEN'S HEALTH RESEARCH 400 00:14:16,249 --> 00:14:19,886 INITIATIVE AND ESTEEMED PANEL 401 00:14:19,886 --> 00:14:21,655 FOR INVITING ME TO BE PART OF 402 00:14:21,655 --> 00:14:24,157 THE CONVERSATION OF 403 00:14:24,157 --> 00:14:24,491 ENDOMETRIOSIS. 404 00:14:24,491 --> 00:14:28,361 FOR THOSE JUST JOINING I'M DIANA 405 00:14:28,361 --> 00:14:33,466 FALZ 406 00:14:33,466 --> 00:14:38,071 FALZONE HOST OF ENDO-TV AND 407 00:14:38,071 --> 00:14:39,673 JOURNALIST AND HERE TO WORK WITH 408 00:14:39,673 --> 00:14:41,708 YOU AND EXPLORE WITH THE 409 00:14:41,708 --> 00:14:44,277 COMMUNITY CAN SUPPORT AND 410 00:14:44,277 --> 00:14:45,679 ADVANCE THE NIH'S INITIATIVE. 411 00:14:45,679 --> 00:14:46,880 I'LL SHARE A BIT ABOUT MY 412 00:14:46,880 --> 00:14:48,982 JOURNEY AS A WAY TO ILLUSTRATE 413 00:14:48,982 --> 00:14:50,383 WHAT IT CAN BE LIKE LIVING WITH 414 00:14:50,383 --> 00:14:52,385 THE DISEASE AND HURDLES THAT CAN 415 00:14:52,385 --> 00:14:53,753 BE POTENTIALLY ENCOUNTERED. 416 00:14:53,753 --> 00:14:57,390 MY STORY I HOPE IS REFLECTIVE OF 417 00:14:57,390 --> 00:14:59,459 MANY OTHERS WHO HAVE 418 00:14:59,459 --> 00:14:59,793 ENDOMETRIOSIS. 419 00:14:59,793 --> 00:15:03,663 I WAS DIAGNOSED IN 2016 AT 32 420 00:15:03,663 --> 00:15:11,204 YEARS OLD WITH ENDOMETRIOSIS AND 421 00:15:11,204 --> 00:15:12,205 INFERTILITY AFTER SUFFERING FROM 422 00:15:12,205 --> 00:15:14,007 HORRIBLE MENSTRUAL CYCLES SINCE 423 00:15:14,007 --> 00:15:15,375 I WAS 11. 424 00:15:15,375 --> 00:15:17,344 DOCTORS TOLD ME IT WAS PART OF 425 00:15:17,344 --> 00:15:18,812 BEING A WOMAN AND SOME HAD IT 426 00:15:18,812 --> 00:15:19,746 WORSE THAN OTHERS. 427 00:15:19,746 --> 00:15:21,715 IT WAS NEVER DEEMED A MEDICAL 428 00:15:21,715 --> 00:15:22,682 CONDITION OR ILLNESS. 429 00:15:22,682 --> 00:15:25,452 I WAS TOLD AT ONE POINT IT WAS 430 00:15:25,452 --> 00:15:27,020 JUST BAD LUCK. 431 00:15:27,020 --> 00:15:31,057 DEBILITATING PAIN, VOMITING, 432 00:15:31,057 --> 00:15:33,159 HEAVY BLEEDING FOR SOMETIMES 14 433 00:15:33,159 --> 00:15:35,495 DAYS, OVARIAN CYSTS THAT WOULD 434 00:15:35,495 --> 00:15:39,699 RUPTURE, LOW-GRADE FEVERS. 435 00:15:39,699 --> 00:15:44,471 ALL THESE ABNORMAL SYMPTOMS WERE 436 00:15:44,471 --> 00:15:51,444 NOT A CONCERN IT WAS JUST A 437 00:15:51,444 --> 00:15:51,845 WOMAN'S BAD LUCK. 438 00:15:51,845 --> 00:15:55,515 FINALLY AT 32 A DOCTOR ACTIVELY 439 00:15:55,515 --> 00:15:57,450 LISTENED AND TOOK ME SERIOUSLY 440 00:15:57,450 --> 00:16:00,253 AND THE SUSPICION THAT I COULD 441 00:16:00,253 --> 00:16:02,956 HAVE ENDOMETRIOSIS LET TO MY 442 00:16:02,956 --> 00:16:07,093 ENDO AND INFERTILITY DIAGNOSIS. 443 00:16:07,093 --> 00:16:09,262 ENDOMETRIOSIS IS A LEADING CAUSE 444 00:16:09,262 --> 00:16:10,430 OF INFERTILITY. 445 00:16:10,430 --> 00:16:14,034 FOR ALL THOSE YEARS I WAS NOT 446 00:16:14,034 --> 00:16:14,934 UNLUCKY, I WAS SICK. 447 00:16:14,934 --> 00:16:17,203 I WAS NOT ALONE. 448 00:16:17,203 --> 00:16:25,445 I WOULD GO ON TO HAVE MULTIPLE 449 00:16:25,445 --> 00:16:33,653 EXITION -- EXCISION SURGERIES 450 00:16:33,653 --> 00:16:38,091 AND I WAS FORTUNATE TO HAVE A 451 00:16:38,091 --> 00:16:38,591 CHILD. 452 00:16:38,591 --> 00:16:43,363 DURING A C SESSION I MHEMORRHAGD 453 00:16:43,363 --> 00:16:43,563 TABLE. 454 00:16:43,563 --> 00:16:45,432 ADDS I BROUGHT MY NEWBORN INTO 455 00:16:45,432 --> 00:16:47,067 THE WORLD I WASN'T SURE IF MY 456 00:16:47,067 --> 00:16:48,701 LIFE WAS SLIPPING AWAY. 457 00:16:48,701 --> 00:16:50,336 IT WAS TERRIFYING. 458 00:16:50,336 --> 00:16:52,338 I RECEIVED BLOOD TRANSFUSIONS 459 00:16:52,338 --> 00:16:53,740 AND MADE A FULL RECOVERY, 460 00:16:53,740 --> 00:16:54,307 THANKFULLY. 461 00:16:54,307 --> 00:16:59,512 I LATER LEARNED A UTERINE 462 00:16:59,512 --> 00:17:02,282 PROCEDURE CAN BE BETTER FOR 463 00:17:02,282 --> 00:17:03,950 SOMEONE WITH ENDOMETRIOSIS. 464 00:17:03,950 --> 00:17:05,452 SEVEN MONTHS AFTER GIVING BIRTH 465 00:17:05,452 --> 00:17:08,154 TO MY SON I ALMOST WENT INTO 466 00:17:08,154 --> 00:17:13,426 KIDNEY FAILURE DUE TO LESIONS 467 00:17:13,426 --> 00:17:19,199 AND FIBROSIS STRANGLING MY 468 00:17:19,199 --> 00:17:21,434 URETERS A MEMBER OF THE SURGICAL 469 00:17:21,434 --> 00:17:22,902 TEAM SAID GOOD THING YOU CAME IN 470 00:17:22,902 --> 00:17:23,369 WHEN YOU DID. 471 00:17:23,369 --> 00:17:25,738 IF YOU WAITED A COUPLE MORE 472 00:17:25,738 --> 00:17:28,408 WEEKS YOU WOULD HAVE BEEN ON 473 00:17:28,408 --> 00:17:28,775 DIALYSIS. 474 00:17:28,775 --> 00:17:31,878 WEEKS PRIOR I HAD LOWER BACK 475 00:17:31,878 --> 00:17:34,614 PAIN IN THE FLANK AREA. 476 00:17:34,614 --> 00:17:38,818 I CHOCKED IT UP TO A MUSCLE PULL 477 00:17:38,818 --> 00:17:41,287 BUT IT BEGAN TO THROB MORE EVERY 478 00:17:41,287 --> 00:17:42,922 DAY AND EXPERIENCED A LOW GRADE 479 00:17:42,922 --> 00:17:44,491 FEVER AND CHILLS AND A DOCTOR 480 00:17:44,491 --> 00:17:45,658 TESTED ME FOR A UTI. 481 00:17:45,658 --> 00:17:47,127 THE TESTS WERE NEGATIVE. 482 00:17:47,127 --> 00:17:50,263 WE CHOCKED IT UP TO PROBABLY 483 00:17:50,263 --> 00:17:51,531 BEING A TIRED NEW MOM WHO 484 00:17:51,531 --> 00:17:53,433 PERHAPS PULLED A MUSCLE IN MY 485 00:17:53,433 --> 00:17:55,668 BACK UNKNOWINGLY. 486 00:17:55,668 --> 00:17:58,972 I ALSO HELD ON TO THE MYTH 487 00:17:58,972 --> 00:18:00,106 ENDOMETRIOSIS WOULD NOT RETURN 488 00:18:00,106 --> 00:18:01,708 TO QUICKLY AFTER HAVING A BABY. 489 00:18:01,708 --> 00:18:03,309 THE SYMPTOMS KEPT PERSISTING. 490 00:18:03,309 --> 00:18:04,844 I WAS NERVOUS. 491 00:18:04,844 --> 00:18:06,980 I SPOKE TO A FRIEND WHO HAD 492 00:18:06,980 --> 00:18:08,815 ADVANCED ENDOMETRIOSIS AND SHE 493 00:18:08,815 --> 00:18:11,718 ENCOURAGED ME TO SPEAK TO MY 494 00:18:11,718 --> 00:18:12,652 ENDO SURGEON ABOUT MY SYMPTOMS. 495 00:18:12,652 --> 00:18:15,655 AT THIS POINT I WAS ALARMINGLY 496 00:18:15,655 --> 00:18:17,524 SICK AND MY SURGEON TOLD ME TO 497 00:18:17,524 --> 00:18:18,691 GO TO THE E.R. 498 00:18:18,691 --> 00:18:20,860 HIS URGING AND BEING ABLE TO 499 00:18:20,860 --> 00:18:23,763 RECOGNIZE THAT MY SYMPTOMS COULD 500 00:18:23,763 --> 00:18:25,665 BE ENDORELATED IS WHAT SAVED MY 501 00:18:25,665 --> 00:18:25,965 KIDNEYS. 502 00:18:25,965 --> 00:18:29,068 I WAS IN SURGERY WITHIN A COUPLE 503 00:18:29,068 --> 00:18:33,239 HOURS AFTER A PELVIC MRI WITH 504 00:18:33,239 --> 00:18:33,506 CONTRAST. 505 00:18:33,506 --> 00:18:37,744 I WAS FORTUNATE TO HAVE 506 00:18:37,744 --> 00:18:42,048 PROXIMITY TO BE TO DOCTORS AND 507 00:18:42,048 --> 00:18:42,682 HEALTH INSURANCE THAT COVERED 508 00:18:42,682 --> 00:18:44,450 MOST THE MEDICAL CARE I NEEDED. 509 00:18:44,450 --> 00:18:46,186 SOMETIMES I THINK ABOUT THE WHAT 510 00:18:46,186 --> 00:18:47,220 IFs. 511 00:18:47,220 --> 00:18:48,821 WHAT COULD HAVE HAPPENED TO ME 512 00:18:48,821 --> 00:18:52,025 OR MY SON IF I WERE NOT HEALTHY 513 00:18:52,025 --> 00:18:53,193 ENOUGH TO TAKE CARE OF HIM AND 514 00:18:53,193 --> 00:18:53,893 THAT STAYS WITH ME. 515 00:18:53,893 --> 00:18:58,631 I LIVE IN FEAR OF MY 516 00:18:58,631 --> 00:18:59,465 ENDOMETRIOSIS ALMOST EVERY DAY. 517 00:18:59,465 --> 00:19:02,535 A DOCTOR ONCE TOLD ME IF YOU 518 00:19:02,535 --> 00:19:05,772 HAVE ENDOMETRIOSIS, YOU ARE A 519 00:19:05,772 --> 00:19:06,573 TICKING TIME BOMB. 520 00:19:06,573 --> 00:19:08,474 YOU'LL NEVER KNOW WHEN YOU'RE 521 00:19:08,474 --> 00:19:10,009 GOING TO GET SICK NEXT. 522 00:19:10,009 --> 00:19:11,544 IN THE UNITED STATES THE AVERAGE 523 00:19:11,544 --> 00:19:14,581 DELAY IN DIAGNOSIS FOR EPIDEMIC 524 00:19:14,581 --> 00:19:16,015 IS 7 TO 12 YEARS. 525 00:19:16,015 --> 00:19:22,388 IT'SE ESTIMATED 1 IN 10 526 00:19:22,388 --> 00:19:26,492 INDIVIDUALS BORN WITH A UTERUS 527 00:19:26,492 --> 00:19:27,927 HAVE EPIDEMIC AND UP TO 528 00:19:27,927 --> 00:19:30,897 TWO-THIRDS ADOLESCENTS WHO 529 00:19:30,897 --> 00:19:34,234 REPORT SEVERE OR PELVIC PAIN 530 00:19:34,234 --> 00:19:35,401 HAVE ENDOMETRIOSIS STARTING 531 00:19:35,401 --> 00:19:35,735 YOUNG. 532 00:19:35,735 --> 00:19:37,070 IT CAN AID IN EARLIER DETECTION 533 00:19:37,070 --> 00:19:37,770 OF THE DISEASE. 534 00:19:37,770 --> 00:19:42,976 I WISH A DOCTOR OR EDUCATOR OR 535 00:19:42,976 --> 00:19:44,410 SOMEONE HAD MENTIONED 536 00:19:44,410 --> 00:19:45,678 ENDOMETRIOSIS AS A YOUNG GIRL. 537 00:19:45,678 --> 00:19:47,714 PERHAPS YEARS OF PAIN AND COSTLY 538 00:19:47,714 --> 00:19:49,449 SURGERIES AND IVF COULD HAVE 539 00:19:49,449 --> 00:19:50,717 BEEN AVOIDED. 540 00:19:50,717 --> 00:19:53,019 AGAIN, I WAS FORTUNATE TO HAVE 541 00:19:53,019 --> 00:19:53,753 ACCESS TO CARE. 542 00:19:53,753 --> 00:19:57,657 THAT IS NOT THE CASE FOR MANY 543 00:19:57,657 --> 00:19:57,890 OTHERS. 544 00:19:57,890 --> 00:20:01,060 I SHARE MY ENDOMETRIOSIS STORY 545 00:20:01,060 --> 00:20:02,328 BECAUSE AS PART OF THIS 546 00:20:02,328 --> 00:20:04,697 COMMUNITY I FEEL A DEEP 547 00:20:04,697 --> 00:20:06,165 RESPONSIBILITY TO HELP AMPLIFY 548 00:20:06,165 --> 00:20:07,467 THE VOICES OF OTHERS LIVING WITH 549 00:20:07,467 --> 00:20:10,436 THIS ILLNESS. 550 00:20:10,436 --> 00:20:12,739 I DISCOVERED ENDOFOUND AND 551 00:20:12,739 --> 00:20:14,874 ACTIVELY ENGAGED IN 2017. 552 00:20:14,874 --> 00:20:16,843 AND GRATEFUL TO THE CO-FOUNDERS 553 00:20:16,843 --> 00:20:18,344 FOR THE LANDMARK WORK THEY'VE 554 00:20:18,344 --> 00:20:20,046 DONE AND CONTINUED TO DO. 555 00:20:20,046 --> 00:20:23,016 I MADE A PROMISE WHEN I WAS 556 00:20:23,016 --> 00:20:26,152 DIAGNOSED WITH ENDO I WOULD HELP 557 00:20:26,152 --> 00:20:28,187 TO ADVOCATE FOR BETTER TREATMENT 558 00:20:28,187 --> 00:20:29,656 OPTIONS AND HOPEFULLY A CURE FOR 559 00:20:29,656 --> 00:20:32,158 THIS INSIDIOUS DISEASE. 560 00:20:32,158 --> 00:20:33,660 WHILE ENDOMETRIOSIS IS GETTING 561 00:20:33,660 --> 00:20:35,295 MORE RECOGNITION, IT'S STILL 562 00:20:35,295 --> 00:20:39,632 CONSIDERED A BENIGN ILLNESS. 563 00:20:39,632 --> 00:20:44,170 PERHAPS IT'S SIMPLY SEMANTICS 564 00:20:44,170 --> 00:20:45,672 BUT A DISEASE THAT HURTS OUR 565 00:20:45,672 --> 00:20:48,241 QUALITY OF LIFE, RELATIONSHIPS, 566 00:20:48,241 --> 00:20:50,877 EDUCATION, MENTAL HEALTH AND 567 00:20:50,877 --> 00:20:53,446 ROBS US POTENTIAL OF OUR BODILY 568 00:20:53,446 --> 00:20:54,747 ORGANS IS NOT A SMALL BURDEN. 569 00:20:54,747 --> 00:20:56,616 THE DISEASE CAN HAVE AN IMPACT 570 00:20:56,616 --> 00:20:57,717 ON MENTAL HEALTH. 571 00:20:57,717 --> 00:21:00,219 UP TO 87% OF THOSE WITH 572 00:21:00,219 --> 00:21:00,753 ENDOMETRIOSIS EXPERIENCE 573 00:21:00,753 --> 00:21:03,790 SYMPTOMS OF ANXIETY AND 574 00:21:03,790 --> 00:21:04,290 DEPRESSION. 575 00:21:04,290 --> 00:21:07,727 IT CERTAINLY DOES NOT FEEL 576 00:21:07,727 --> 00:21:08,328 BENIGN. 577 00:21:08,328 --> 00:21:09,262 ENDOMETRIOSIS CAN BE A CHRONIC 578 00:21:09,262 --> 00:21:10,897 LIFE LONG ILLNESS. 579 00:21:10,897 --> 00:21:12,198 THOSE WITH ENDOMETRIOSIS NEED 580 00:21:12,198 --> 00:21:14,133 THE MEDICAL COMMUNITY AT LARGE 581 00:21:14,133 --> 00:21:21,441 TO NOT MINIMIZE THE LITERAL AND 582 00:21:21,441 --> 00:21:23,576 FIGURATIVE COST. 583 00:21:23,576 --> 00:21:25,411 HIGHLIGHTS SHOW THE BURDEN 584 00:21:25,411 --> 00:21:27,313 ANNUAL COST IN THE UNITED STATES 585 00:21:27,313 --> 00:21:27,914 ESTIMATED IN THE BILLIONS OF 586 00:21:27,914 --> 00:21:30,583 DOLLARS. 587 00:21:30,583 --> 00:21:33,086 PEOPLE WITH ENDOMETRIOSIS CAN 588 00:21:33,086 --> 00:21:36,823 FACE UP TO THREE TIMES HIGHER 589 00:21:36,823 --> 00:21:38,191 HEALTH CARE COST AND LOST 590 00:21:38,191 --> 00:21:40,660 PRODUCTIVITY COMPARED TO THOSE 591 00:21:40,660 --> 00:21:42,195 WITHOUT THE DISEASE. 592 00:21:42,195 --> 00:21:43,496 ENDOMETRIOSIS SYSTEMS BEGIN 593 00:21:43,496 --> 00:21:46,799 DURING ADOLESCENTS SO EDUCATING 594 00:21:46,799 --> 00:21:48,668 USE IS CRUCIAL IN THE TREATMENT 595 00:21:48,668 --> 00:21:50,536 AND PAIN OF ENDOMETRIOSIS THAT 596 00:21:50,536 --> 00:21:53,239 RESULTS IN YEARS OF UNNECESSARY 597 00:21:53,239 --> 00:21:54,574 PAIN AND SUFFERING. 598 00:21:54,574 --> 00:21:56,342 FINDING PROPER TREATMENT, 599 00:21:56,342 --> 00:21:57,977 ADVOCATING FOR THEIR NEEDS AND 600 00:21:57,977 --> 00:21:59,879 MAKING WELL INFORMED HEALTH 601 00:21:59,879 --> 00:22:02,782 CHOICES CAN ENHANCE THEIR DAILY 602 00:22:02,782 --> 00:22:03,049 LIVE. 603 00:22:03,049 --> 00:22:08,454 I'VE SPOKEN TO DOZENS OF 604 00:22:08,454 --> 00:22:12,959 INDIVIDUALS WHO SUFFERED FROM 605 00:22:12,959 --> 00:22:14,627 PELVIC ENDOMETRIOSIS AND SOME 606 00:22:14,627 --> 00:22:17,764 HAVE LOST KIDNEY FUNCTION OR 607 00:22:17,764 --> 00:22:21,434 HAVE HAD REPRODUCTIVE ORGANS 608 00:22:21,434 --> 00:22:28,941 REMOVED BEFORE REALIZING THEIR 609 00:22:28,941 --> 00:22:29,342 PARENTHOOD. 610 00:22:29,342 --> 00:22:32,445 IT CAN LEAVE YOU FEELING 611 00:22:32,445 --> 00:22:33,379 HOPELESS, YET THERE'S HOPE 612 00:22:33,379 --> 00:22:35,715 BECAUSE WE ARE HERE TODAY HAVING 613 00:22:35,715 --> 00:22:37,617 THIS PIVOTAL CONVERSATION WITH 614 00:22:37,617 --> 00:22:39,886 PEOPLE WHO CAN MAKE A 615 00:22:39,886 --> 00:22:40,186 DIFFERENCE. 616 00:22:40,186 --> 00:22:41,154 KNOWLEDGE IS POWER ESPECIALLY 617 00:22:41,154 --> 00:22:44,757 WHEN IT COMES TO UNDERSTANDING 618 00:22:44,757 --> 00:22:46,492 ENDOMETRIOSIS AS A PATIENT. 619 00:22:46,492 --> 00:22:47,794 EMPOWERS INDIVIDUALS TO 620 00:22:47,794 --> 00:22:49,896 RECOGNIZE THE SIGNS AND SYMPTOMS 621 00:22:49,896 --> 00:22:53,332 OF THE ILLNESS EARLY POTENTIALLY 622 00:22:53,332 --> 00:22:55,168 PREVENTING FURTHER PROGRESSION. 623 00:22:55,168 --> 00:22:56,235 WITH KNOWLEDGE PATIENTS CAN 624 00:22:56,235 --> 00:22:58,538 ADVOCATE FOR THEMSELVES AND SEEK 625 00:22:58,538 --> 00:22:59,205 APPROPRIATE TREATMENT AND MAKE 626 00:22:59,205 --> 00:23:01,340 INFORMED DECISIONS ABOUT THEIR 627 00:23:01,340 --> 00:23:02,241 HEALTH ULTIMATELY IMPROVING 628 00:23:02,241 --> 00:23:03,409 THEIR QUALITY OF LIFE. 629 00:23:03,409 --> 00:23:05,445 I'M ONLY ONE VOICE. 630 00:23:05,445 --> 00:23:07,113 I'M ONLY ONE ENDOMETRIOSIS STORY 631 00:23:07,113 --> 00:23:10,716 AMONG THOUSANDS BUT TOGETHER 632 00:23:10,716 --> 00:23:12,251 WE'RE STRONGER. 633 00:23:12,251 --> 00:23:13,319 TOGETHER WE CAN MAKE A 634 00:23:13,319 --> 00:23:13,753 DIFFERENCE. 635 00:23:13,753 --> 00:23:16,622 I'M GRATEFUL TO THOSE IN THE 636 00:23:16,622 --> 00:23:17,290 ENDOMETRIOSIS COMMUNITY WHO LEND 637 00:23:17,290 --> 00:23:20,026 THEIR VOICES, RESOURCES AND 638 00:23:20,026 --> 00:23:21,060 SUPPORT TIME AND TIME AGAIN. 639 00:23:21,060 --> 00:23:24,096 I'M GRATEFUL TO EACH OF YOU 640 00:23:24,096 --> 00:23:24,997 PRESENT TODAY. 641 00:23:24,997 --> 00:23:27,667 WE SHARE A COMMON GOAL TO STRIVE 642 00:23:27,667 --> 00:23:29,168 FOR ERADICATING THE DELAY IN 643 00:23:29,168 --> 00:23:30,803 DIAGNOSIS IMPROVING TREATMENTS 644 00:23:30,803 --> 00:23:32,271 OPTIONS AND CONDUCTING MORE 645 00:23:32,271 --> 00:23:35,408 RESEARCH TO LEAD TO, I HOPE, 646 00:23:35,408 --> 00:23:36,943 ERADICATING THIS ILLNESS. 647 00:23:36,943 --> 00:23:39,045 TOGETHER WE CAN TRANSFORM THE 648 00:23:39,045 --> 00:23:41,681 LIVE OF MILLIONS AFFECTED BY 649 00:23:41,681 --> 00:23:44,183 ENDOMETRIOSIS BY UNITING OUR 650 00:23:44,183 --> 00:23:45,985 EFFORTS AND INVESTING IN 651 00:23:45,985 --> 00:23:47,320 RESEARCH WE CAN MAKE STRIDES FOR 652 00:23:47,320 --> 00:23:48,654 THOSE SUFFERING FROM THIS 653 00:23:48,654 --> 00:23:49,422 DEBILITATING DISEASE. 654 00:23:49,422 --> 00:23:58,464 THANK YOU FOR YOUR TIME. 655 00:23:58,464 --> 00:24:00,166 >> I HOPE YOU CAN SEE THE 656 00:24:00,166 --> 00:24:01,434 RESPONSE FROM THE AUDIENCE 657 00:24:01,434 --> 00:24:02,168 INCREDIBLY POSITIVE. 658 00:24:02,168 --> 00:24:03,970 YOU'RE SAYING WORDS MANY OF THE 659 00:24:03,970 --> 00:24:06,005 PEOPLE IN THE ROOM HAVE SAID 660 00:24:06,005 --> 00:24:07,440 THEMSELVES, FELT THEMSELVES. 661 00:24:07,440 --> 00:24:15,748 SO JUST FROM THE AUDIENCE, I 662 00:24:15,748 --> 00:24:17,316 THINK YOU'RE INSPIRING TO THINK 663 00:24:17,316 --> 00:24:18,050 ABOUT THE ENDOMETRIOSIS 664 00:24:18,050 --> 00:24:19,585 COMMUNITY AND HOW BENEFICIAL 665 00:24:19,585 --> 00:24:21,521 THAT IS AND HOW THEY MIGHT START 666 00:24:21,521 --> 00:24:22,188 THAT OUT. 667 00:24:22,188 --> 00:24:25,591 I ALSO WANT TO CONGRATULATE YOU 668 00:24:25,591 --> 00:24:27,393 FOR BEING INCLUSIVE OF THE TRANS 669 00:24:27,393 --> 00:24:29,695 AND NON-BINARY FOLKS IN OUR 670 00:24:29,695 --> 00:24:29,962 COMMUNITY. 671 00:24:29,962 --> 00:24:33,466 AS WE KNOW ANYONE WITH A UTERUS 672 00:24:33,466 --> 00:24:34,433 CAN SUFFER FROM ENDOMETRIOSIS. 673 00:24:34,433 --> 00:24:36,802 I WANTED TO SPIN OFF ON MAYBE 674 00:24:36,802 --> 00:24:38,871 ONE QUESTION BEFORE WE TURN TO 675 00:24:38,871 --> 00:24:39,639 OUR NEXT SPEAKER. 676 00:24:39,639 --> 00:24:42,441 WHAT WOULD YOU SAY TO THESE 677 00:24:42,441 --> 00:24:45,077 PEOPLE IN RURAL COMMUNITIES WHO 678 00:24:45,077 --> 00:24:47,680 WANT TO JUST GET STARTED FINDING 679 00:24:47,680 --> 00:24:49,048 OTHERS LIKE THEM OR STARTING 680 00:24:49,048 --> 00:24:49,415 SUPPORT GROUP. 681 00:24:49,415 --> 00:24:53,452 DO YOU HAVE ADVICE THERE. 682 00:24:53,452 --> 00:24:56,889 >> SOCIAL MEDIA IS LIKE AN EVIL 683 00:24:56,889 --> 00:24:58,691 MISTRESS AND GOOD AND BAD. 684 00:24:58,691 --> 00:25:03,162 FOR ME THE REASON I FOUND 685 00:25:03,162 --> 00:25:05,531 ENDOFOUND IS BECAUSE OF 686 00:25:05,531 --> 00:25:05,798 INSTAGRAM. 687 00:25:05,798 --> 00:25:08,434 I SAW A STORY AND IT CONNECTED 688 00:25:08,434 --> 00:25:09,302 ME TO THE WEBSITE. 689 00:25:09,302 --> 00:25:11,604 I WAS ABLE TO CONNECT WITH 690 00:25:11,604 --> 00:25:16,676 OTHERS THAT HAD ENDOMETRIOSIS. 691 00:25:16,676 --> 00:25:18,210 THAT'S WHERE I LEARNED AND 692 00:25:18,210 --> 00:25:21,447 LEARNED ABOUT THINGS NOT 693 00:25:21,447 --> 00:25:22,014 NECESSARILY TALKED ABOUT SO 694 00:25:22,014 --> 00:25:32,124 MUCH. 695 00:25:34,827 --> 00:25:38,130 AND IF YOU'RE NOT IN A MAJOR 696 00:25:38,130 --> 00:25:40,566 CITY WHERE YOU MAY BE ABLE TO 697 00:25:40,566 --> 00:25:42,234 REACH OUT OR HAVE 698 00:25:42,234 --> 00:25:43,002 ENDOSPECIALISTS THAT CAN SPEAK 699 00:25:43,002 --> 00:25:43,235 TO YOU. 700 00:25:43,235 --> 00:25:45,671 I THINK IT'S IMPORTANT TO HAVE 701 00:25:45,671 --> 00:25:56,148 THAT SUPPORT SYSTEM. 702 00:25:56,148 --> 00:25:57,583 I HAVE FRIENDS ALL OVER THE 703 00:25:57,583 --> 00:25:58,250 UNITED STATES AND WE COLLABORATE 704 00:25:58,250 --> 00:25:59,485 FROM MENTAL HEALTH TO OUR 705 00:25:59,485 --> 00:26:01,721 DISEASE SYMPTOMS. 706 00:26:01,721 --> 00:26:02,755 >> FANTASTIC. 707 00:26:02,755 --> 00:26:04,690 THANK YOU SO MUCH FOR SHARING 708 00:26:04,690 --> 00:26:04,890 THAT. 709 00:26:04,890 --> 00:26:06,859 SO WE WILL HAVE YOU BACK AT THE 710 00:26:06,859 --> 00:26:09,428 END OF THE SESSION TO TALK WITH 711 00:26:09,428 --> 00:26:11,063 OUR ENTIRE PANEL. 712 00:26:11,063 --> 00:26:13,699 ALL THOSE IN THE AUDIENCE WITH 713 00:26:13,699 --> 00:26:15,668 LINGERING QUESTIONS PUT THOSE IN 714 00:26:15,668 --> 00:26:17,436 THE Q&A AND WE'LL BRING HER BACK 715 00:26:17,436 --> 00:26:18,638 TO DISCUSS THOSE LATER. 716 00:26:18,638 --> 00:26:21,040 THANK YOU, DIANA. 717 00:26:21,040 --> 00:26:24,343 NOW WE'LL TURN TO DR. STACEY 718 00:26:24,343 --> 00:26:26,178 MISSMER WITH HER TALK 719 00:26:26,178 --> 00:26:27,680 ENDOMETRIOSIS WHOLE HEALTH 720 00:26:27,680 --> 00:26:30,883 ACROSS WHOLE LIVES. 721 00:26:30,883 --> 00:26:31,651 >> THANK YOU. 722 00:26:31,651 --> 00:26:33,185 IT'S ALWAYS A PLEASURE TO FOLLOW 723 00:26:33,185 --> 00:26:35,021 DIANA AND THE AMAZING WORK SHE 724 00:26:35,021 --> 00:26:37,256 AND THE ADVOCATES ARE DOING. 725 00:26:37,256 --> 00:26:39,325 I'M GOING TO TALK ABOUT WHERE WE 726 00:26:39,325 --> 00:26:43,295 ARE IN TERMS OF RESEARCH 727 00:26:43,295 --> 00:26:47,433 DISCOVERY AT A 10,000 FOOT LEVEL 728 00:26:47,433 --> 00:26:49,702 IN TERMS OF SEVERAL DIFFERENT 729 00:26:49,702 --> 00:26:54,407 ASPECTS OF ENDOMETRIOSIS. 730 00:26:54,407 --> 00:27:04,750 SO AS WE KNOW IT'S DEFINED BY 731 00:27:04,750 --> 00:27:05,584 ENDOMETRIAL TISSUE OUTSIDE THE 732 00:27:05,584 --> 00:27:09,155 CAST AND CAN AFFECT THE LUNG, 733 00:27:09,155 --> 00:27:13,426 HEART AND BRAIN AND HAVE 734 00:27:13,426 --> 00:27:14,460 MULTI-SYSTEM IMPACT. 735 00:27:14,460 --> 00:27:19,899 IT'S ESTROGEN DEPENDENT AND 736 00:27:19,899 --> 00:27:22,268 PROGESTERONE RESISTANT AND AN 737 00:27:22,268 --> 00:27:24,537 INFLAMMATORY CONDITION. 738 00:27:24,537 --> 00:27:27,506 WE KNOW THE STANDARD ESTIMATE IS 739 00:27:27,506 --> 00:27:28,607 1 IN 10 WOMEN. 740 00:27:28,607 --> 00:27:33,245 I'LL COME BACK TO THAT IN A 741 00:27:33,245 --> 00:27:37,483 MOMENT AVERAGING MORE THAN 200 742 00:27:37,483 --> 00:27:39,151 MILLION WORLDWIDE AFFECTED WE 743 00:27:39,151 --> 00:27:42,354 KNOW IT'S A LONG PATHWAY FOR 744 00:27:42,354 --> 00:27:44,857 MOST PATIENTS TO DIAGNOSIS AND 745 00:27:44,857 --> 00:27:48,794 THERE'S CURRENTLY NO CURE AND A 746 00:27:48,794 --> 00:27:50,629 THIRD OF WOMEN FEEL THE CURRENT 747 00:27:50,629 --> 00:27:52,832 TREATMENT IS NOT EFFECTIVE. 748 00:27:52,832 --> 00:27:55,768 WHEN WE THINK WITH THE 749 00:27:55,768 --> 00:27:58,637 PREVALENCE OF THE 69 STUDIES TO 750 00:27:58,637 --> 00:28:03,175 DATE THE RANGE LOOKS AT CLINIC 751 00:28:03,175 --> 00:28:05,077 POPULATIONS TO NATIONAL 752 00:28:05,077 --> 00:28:07,113 REGISTRIES RANGES WIDELY FROM 1% 753 00:28:07,113 --> 00:28:07,880 TO 72%. 754 00:28:07,880 --> 00:28:12,952 SO WE'RE NOT CLEAR ON THE 755 00:28:12,952 --> 00:28:14,687 ABSOLUTE NUMBER OF GIRLS AND 756 00:28:14,687 --> 00:28:16,388 WOMEN WHO HAVE ENDOMETRIOSIS. 757 00:28:16,388 --> 00:28:18,691 WE KNOW THERE ARE SEVERAL 758 00:28:18,691 --> 00:28:21,427 PATHWAYS AGAIN AS DIANA 759 00:28:21,427 --> 00:28:24,330 DESCRIBED SO IMPACTFUL THERE ARE 760 00:28:24,330 --> 00:28:26,031 PATHWAYS WHERE THE SYMPTOMS OF 761 00:28:26,031 --> 00:28:29,502 ENDOMETRIOSIS ARE NORMALIZED AND 762 00:28:29,502 --> 00:28:30,803 DISMISSED WHEN PATIENTS PRESENT 763 00:28:30,803 --> 00:28:31,771 TO DISCUSS THE SYMPTOMS. 764 00:28:31,771 --> 00:28:35,407 WE KNOW MANY DON'T HAVE ACCESS 765 00:28:35,407 --> 00:28:37,543 TO CARE TO ADDRESS THESE 766 00:28:37,543 --> 00:28:37,977 SYMPTOMS. 767 00:28:37,977 --> 00:28:39,512 WE KNOW SOME DON'T RESPOND TO 768 00:28:39,512 --> 00:28:41,180 STANDARDS OF TREATMENT AND ARE 769 00:28:41,180 --> 00:28:45,885 LEFT WITH NO FURTHER AAVENUES TO 770 00:28:45,885 --> 00:28:47,453 PURSUE AND SOME HAVE SUCCESSFUL 771 00:28:47,453 --> 00:28:48,788 AND PURE TREATMENT AND THEREFORE 772 00:28:48,788 --> 00:28:53,959 NOT GO ON TO A FURTHER ACCURATE 773 00:28:53,959 --> 00:28:54,527 DIAGNOSIS OF ENDOMETRIOSIS. 774 00:28:54,527 --> 00:28:57,163 WHAT WE FOCUSSED ON FOR 775 00:28:57,163 --> 00:28:59,398 ENDOMETRIOSIS ACROSS A WOMAN'S 776 00:28:59,398 --> 00:29:01,400 LIFE COURSE IS PRIMARILY WE'VE 777 00:29:01,400 --> 00:29:02,968 LOOKED AT THE PERIOD OF 778 00:29:02,968 --> 00:29:03,669 ADULTHOOD. 779 00:29:03,669 --> 00:29:07,173 MOSTLY WOMEN IN THEIR 30s AND 780 00:29:07,173 --> 00:29:08,607 40s. 781 00:29:08,607 --> 00:29:09,909 HOWEVER WE KNOW THE SYMPTOMS 782 00:29:09,909 --> 00:29:12,611 MOST COMMONLY BEGIN IN 783 00:29:12,611 --> 00:29:15,648 ADOLESCENCE AND CONTINUE PAST 784 00:29:15,648 --> 00:29:16,282 MENOPAUSE. 785 00:29:16,282 --> 00:29:17,449 WE KNOW RISK FACTORS AS WE'RE 786 00:29:17,449 --> 00:29:19,451 TRYING TO DETERMINE WHAT ARE THE 787 00:29:19,451 --> 00:29:22,121 CAUSAL PATHWAYS THAT CAN BE 788 00:29:22,121 --> 00:29:24,924 INTERVENED UPON, POSSIBLY 789 00:29:24,924 --> 00:29:26,325 PREVENTED AND CERTAINLY 790 00:29:26,325 --> 00:29:28,127 CAPITALIZED FOR SUCCESSFUL 791 00:29:28,127 --> 00:29:32,331 TREATMENT VARY BY WINDOW OF 792 00:29:32,331 --> 00:29:34,433 EXPOSURE. 793 00:29:34,433 --> 00:29:35,134 CONSISTENTLY I'LL GO THROUGH 794 00:29:35,134 --> 00:29:38,938 THESE SUPERFICIALLY. 795 00:29:38,938 --> 00:29:43,309 THOSE WITH A LOWER BIRTH WEIGHT 796 00:29:43,309 --> 00:29:46,278 HAVE HIGHER DIAGNOSIS AND LOWER 797 00:29:46,278 --> 00:29:50,883 AGE OF MENARCHE AND UNDER 798 00:29:50,883 --> 00:29:53,452 STUDIED IS PHYSICAL ACTIVITY AND 799 00:29:53,452 --> 00:29:56,689 SMOKING EXPOSURE RELATED TO 800 00:29:56,689 --> 00:29:57,022 ENDOMETRIOSIS. 801 00:29:57,022 --> 00:29:59,225 THE MOST STUDIED IS IN ADULT 802 00:29:59,225 --> 00:29:59,592 EXPOSURES. 803 00:29:59,592 --> 00:30:01,427 CONFIRMED RIGOROUS FINDINGS 804 00:30:01,427 --> 00:30:04,630 AROUND SHORTER MENSTRUAL CYCLE 805 00:30:04,630 --> 00:30:07,466 LENGTHS, MORE FREQUENT PERIODS, 806 00:30:07,466 --> 00:30:09,435 LOWER BODY MASS INDEX AND THEN 807 00:30:09,435 --> 00:30:12,271 WE HAVE A LOT OF INCONSISTENT 808 00:30:12,271 --> 00:30:13,772 STUDY AND UNDER STUDIED 809 00:30:13,772 --> 00:30:14,073 EVALUATIONS. 810 00:30:14,073 --> 00:30:18,878 SO THIS IS WHERE MOST THE 811 00:30:18,878 --> 00:30:21,447 DIETARY RELATIONSHIPS BETWEEN 812 00:30:21,447 --> 00:30:23,983 ENDOMETRIOSIS AND SYMPTOMS FALL. 813 00:30:23,983 --> 00:30:27,686 WE KNOW AND THIS HAS BEEN 814 00:30:27,686 --> 00:30:30,923 IMPORTANT EMERGING INFORMATION 815 00:30:30,923 --> 00:30:32,892 FOCUSSED ON THE LAST FEW YEARS. 816 00:30:32,892 --> 00:30:35,594 WOMEN WITH ENDOMETRIOSIS HAVE A 817 00:30:35,594 --> 00:30:36,195 DIVERSE PRESENTATION AND 818 00:30:36,195 --> 00:30:36,595 EXPERIENCE. 819 00:30:36,595 --> 00:30:41,267 IF WE LOOK AT SYMPTOMS, THE 820 00:30:41,267 --> 00:30:42,501 MAJORITY ARE EXPERIENCING 821 00:30:42,501 --> 00:30:45,404 CHRONIC PAIN OFTEN, 822 00:30:45,404 --> 00:30:47,373 DYSMENORRHEA, PAIN DURING 823 00:30:47,373 --> 00:30:48,841 MENSTRUATION AND OTHER TIMES OF 824 00:30:48,841 --> 00:30:52,478 THE MENSTRUAL CYCLE, PAINFUL 825 00:30:52,478 --> 00:30:54,580 DEFECATION AND HIGH PREVALENCE 826 00:30:54,580 --> 00:30:56,382 OF FATIGUE. 827 00:30:56,382 --> 00:30:58,684 WE ALSO KNOW THAT THE 828 00:30:58,684 --> 00:30:59,318 PRESENTATION OF ENDOMETRIOSIS 829 00:30:59,318 --> 00:31:01,620 ITSELF AND WHAT WE SEE IN THE 830 00:31:01,620 --> 00:31:03,689 LESIONS IS DIFFERENT FROM ONE 831 00:31:03,689 --> 00:31:14,066 PATIENT TO TO ANOTHER. 832 00:31:23,042 --> 00:31:33,519 THERE'S PERITINEAL AND THE CYSTS 833 00:31:35,754 --> 00:31:36,388 RELATED TO ENDOMETRIOSIS. 834 00:31:36,388 --> 00:31:38,657 WHILE WE LOOK AT THE LESION 835 00:31:38,657 --> 00:31:41,427 TYPES IT GIVES US AN IMPORTANT 836 00:31:41,427 --> 00:31:44,530 TUND TO ADVANCE DISCOVERY THAT 837 00:31:44,530 --> 00:31:45,431 IMPROVES DIAGNOSIS AND 838 00:31:45,431 --> 00:31:51,070 TREATMENT. 839 00:31:51,070 --> 00:31:53,872 TO THE DATA COMES FROM 840 00:31:53,872 --> 00:31:56,208 REVOLUTIONARY DISCOVERY IN THE 841 00:31:56,208 --> 00:31:56,575 SUBPHENOTYPES. 842 00:31:56,575 --> 00:32:02,147 IN THE GENETICS REALM WE KNOW WE 843 00:32:02,147 --> 00:32:08,020 FOUND 42 GENES ASSOCIATED 844 00:32:08,020 --> 00:32:09,421 HOWEVER, WHEN WE LOOK MORE 845 00:32:09,421 --> 00:32:13,359 CLOSELY IT'S GENES ASSOCIATED 846 00:32:13,359 --> 00:32:14,994 WITH OVARIAN CYSTS. 847 00:32:14,994 --> 00:32:17,296 NEW DISCOVERIES ARE LOOKING TO 848 00:32:17,296 --> 00:32:21,367 FIND GENES THAT MAY BE SPECIFIC 849 00:32:21,367 --> 00:32:23,369 TO SUPERFICIAL AND DEEP LESIONS 850 00:32:23,369 --> 00:32:25,104 TO HELP UNDERSTAND DIAGNOSTICS 851 00:32:25,104 --> 00:32:27,673 AND ALSO THE CAUSAL PANEL WAYS 852 00:32:27,673 --> 00:32:28,874 TO BE INTERVENED UPON. 853 00:32:28,874 --> 00:32:31,977 WE HAVE EMERGING INFORMATION 854 00:32:31,977 --> 00:32:34,346 AROUND PROTEIN PROFILES. 855 00:32:34,346 --> 00:32:35,881 RECENTLY THERE'S BEEN 856 00:32:35,881 --> 00:32:39,785 DISCOVERIES THE PROTEIN PATHWAYS 857 00:32:39,785 --> 00:32:40,853 ASSOCIATED WITH ENDOMETRIOSIS 858 00:32:40,853 --> 00:32:42,821 DIFFER BY THE TYPE OF PAIN 859 00:32:42,821 --> 00:32:45,391 SYMPTOMS PATIENTS ARE 860 00:32:45,391 --> 00:32:45,724 EXPERIENCING. 861 00:32:45,724 --> 00:32:50,996 THEY ALSO DIFFER BY RESPOND TO 862 00:32:50,996 --> 00:32:51,563 CURRENT TREATMENTS. 863 00:32:51,563 --> 00:32:53,966 THIS IS A REVOLUTIONARY AREA WE 864 00:32:53,966 --> 00:32:57,436 EXPECT LEAPS AND BOUNDS FORWARD 865 00:32:57,436 --> 00:32:59,038 IN THE NEXT FIVE YEARS OR SO. 866 00:32:59,038 --> 00:33:01,440 AND WE KNOW THOSE WITH 867 00:33:01,440 --> 00:33:02,708 ENDOMETRIOSIS EXPERIENCE HIGH 868 00:33:02,708 --> 00:33:04,309 RISK OF HAVING OTHER CONDITIONS. 869 00:33:04,309 --> 00:33:09,681 SO WE KNOW THERE'S HIGHER RISK 870 00:33:09,681 --> 00:33:18,457 OF ADENO MYOSIS AND HIGHER RISK 871 00:33:18,457 --> 00:33:19,992 OF CO-OCCURRENCE WITH UTERINE 872 00:33:19,992 --> 00:33:20,826 FIBROIDS AND THOSE WITH 873 00:33:20,826 --> 00:33:22,761 ENDOMETRIOSIS HAVE A HIGHER RISK 874 00:33:22,761 --> 00:33:25,030 OF EXPERIENCING INFERTILITY. 875 00:33:25,030 --> 00:33:27,666 ALSO WE HAVE QUITE A BIT OF 876 00:33:27,666 --> 00:33:30,536 EMERGING INFORMATION AROUND THE 877 00:33:30,536 --> 00:33:34,473 OTHER SYMPTOMS AND IMPACT OF 878 00:33:34,473 --> 00:33:34,940 ENDOMETRIOSIS BEYOND 879 00:33:34,940 --> 00:33:36,375 REPRODUCTIVE AND GYNECOLOGIC 880 00:33:36,375 --> 00:33:36,775 SYMPTOMS. 881 00:33:36,775 --> 00:33:40,979 WE'RE 15 YEARS IN NOW TO TALKING 882 00:33:40,979 --> 00:33:42,347 ABOUT ENDOMETRIOSIS AS A 883 00:33:42,347 --> 00:33:45,050 MULTI-SYSTEMIC IMPACTFUL 884 00:33:45,050 --> 00:33:45,317 CONDITION. 885 00:33:45,317 --> 00:33:47,586 AND THERE'S A LOT OF BIOLOGIC 886 00:33:47,586 --> 00:33:51,123 AND CLINICAL UNDER PINNINGS TO 887 00:33:51,123 --> 00:33:52,591 WHY THERE WOULD BE LARGE SCALE 888 00:33:52,591 --> 00:33:54,259 LIFE LONG IMPACTS OF 889 00:33:54,259 --> 00:33:55,160 ENDOMETRIOSIS. 890 00:33:55,160 --> 00:34:00,032 SO CHANGES IN THE INFLAMMATORY 891 00:34:00,032 --> 00:34:02,267 MILIEU, CHRONIC INFLAMMATION, 892 00:34:02,267 --> 00:34:03,402 OXIDATIVE STRESS, STEM CELL 893 00:34:03,402 --> 00:34:07,873 ACTIVITY CHANGE AND COAGULATION 894 00:34:07,873 --> 00:34:10,142 AND MALIGNANT TRANSFORMATIONS 895 00:34:10,142 --> 00:34:13,445 AND SHARED GENETICS AND SHARED 896 00:34:13,445 --> 00:34:15,347 PATHWAYS IN PHYSIOLOGY BETWEEN 897 00:34:15,347 --> 00:34:15,881 ENDOMETRIOSIS AND OTHER 898 00:34:15,881 --> 00:34:18,217 CONDITIONS AND SHARED RISK 899 00:34:18,217 --> 00:34:19,651 FACTORS AND OF PARTICULAR 900 00:34:19,651 --> 00:34:21,453 INTEREST ARE WHAT WE UNDERSTAND 901 00:34:21,453 --> 00:34:22,955 ABOUT THE BIOLOGY OF THOSE RISK 902 00:34:22,955 --> 00:34:25,390 FACTORS SO THAT AGAIN WE CAN 903 00:34:25,390 --> 00:34:27,359 INTERVENE UPON THEM AND PREVENT 904 00:34:27,359 --> 00:34:29,561 THEM AND ALSO SO WE CAN 905 00:34:29,561 --> 00:34:32,498 UNDERSTAND BETTER THE BIOLOGY OF 906 00:34:32,498 --> 00:34:33,665 ENDOMETRIOSIS AND PERHAPS 907 00:34:33,665 --> 00:34:36,535 DEVELOP NEW TARGETED 908 00:34:36,535 --> 00:34:38,303 PERSONALIZED TREATMENTS. 909 00:34:38,303 --> 00:34:40,939 SO TO DATE THERE ARE CONDITIONS 910 00:34:40,939 --> 00:34:45,444 IN MOST SYSTEMS OF THE HUMAN 911 00:34:45,444 --> 00:34:46,845 BODY RELATED TO ENDOMETRIOSIS. 912 00:34:46,845 --> 00:34:49,248 MANY CHRONIC OVERLAPPING PAIN 913 00:34:49,248 --> 00:34:53,185 CONDITIONS, BLADDER PAIN, 914 00:34:53,185 --> 00:34:55,120 IRRITABLE BOWEL SYNDROME AND 915 00:34:55,120 --> 00:34:57,456 IMPACTS ON THE CARDIOVASCULAR 916 00:34:57,456 --> 00:35:00,192 AND CEREBRAL VASCULAR SYMPTOMS. 917 00:35:00,192 --> 00:35:01,660 INCREASED RISK OF EARLIER 918 00:35:01,660 --> 00:35:02,594 MENOPAUSE. 919 00:35:02,594 --> 00:35:06,365 SEVERAL TYPE OF CANCERS 920 00:35:06,365 --> 00:35:07,933 PARTICULARLY THYROID AND SMALL 921 00:35:07,933 --> 00:35:09,434 INCREASED RISK OF BREAST CANCER, 922 00:35:09,434 --> 00:35:12,304 OVARIAN CANCER IS THE MOST WELL 923 00:35:12,304 --> 00:35:14,673 KNOWN ASSOCIATION. 924 00:35:14,673 --> 00:35:17,342 ALSO ASTHMA, ECZEMA AND EMERGING 925 00:35:17,342 --> 00:35:19,011 INFORMATION ABOUT LONG COVID AND 926 00:35:19,011 --> 00:35:22,514 THE IMPACT OF COVID INFECTION ON 927 00:35:22,514 --> 00:35:26,985 THE LONGER TERM HEALTH OF THOSE 928 00:35:26,985 --> 00:35:27,786 WITH ENDOMETRIOSIS. 929 00:35:27,786 --> 00:35:31,456 THE KEY ISSUES WE WANT IT FOCUS 930 00:35:31,456 --> 00:35:34,326 IN TERMS OF CHRONIC CONDITIONS 931 00:35:34,326 --> 00:35:37,229 MANY EVEN MOST STILL REMAIN RARE 932 00:35:37,229 --> 00:35:39,131 AND INFREQUENT AND WOMEN WITH 933 00:35:39,131 --> 00:35:40,465 ENDOMETRIOSIS HAVE A HIGHER 934 00:35:40,465 --> 00:35:41,533 RISK. 935 00:35:41,533 --> 00:35:44,236 WE NEED TO UNDERSTAND BETTER WHO 936 00:35:44,236 --> 00:35:45,370 IS AT HIGHER RISK. 937 00:35:45,370 --> 00:35:47,206 WE NEED TO UNDERSTAND THE 938 00:35:47,206 --> 00:35:53,345 BIOLOGY AND ENVIRONMENTAL AND 939 00:35:53,345 --> 00:35:54,513 POTENTIALLY MODIFIABLE FACTORS 940 00:35:54,513 --> 00:35:55,214 INFLUENCING THE HEALTH AND 941 00:35:55,214 --> 00:35:57,049 WELLNESS OF THOSE WITH 942 00:35:57,049 --> 00:35:58,217 ENDOMETRIOSIS TO BETTER PREDICT 943 00:35:58,217 --> 00:36:00,552 WHO IS AT RISK FOR OTHER 944 00:36:00,552 --> 00:36:02,654 CONDITIONS AND HELPFULLY 945 00:36:02,654 --> 00:36:03,689 PREVENTION AND AVERAGEMENT OF 946 00:36:03,689 --> 00:36:04,590 NOVEL TREATMENTS. 947 00:36:04,590 --> 00:36:11,396 WE ALSO REALLY HAVE TO SOLIDIFY 948 00:36:11,396 --> 00:36:12,731 THAT ENDOMETRIOSIS IS IMPORTANT 949 00:36:12,731 --> 00:36:15,300 BEYOND THE GYNECOLOGIST'S CARE 950 00:36:15,300 --> 00:36:19,238 AND BEYOND GYNECOLOGY FOCUSSING 951 00:36:19,238 --> 00:36:20,439 ON FUNDING AGENCIES AND RESEARCH 952 00:36:20,439 --> 00:36:22,741 DISCOVERY AND REALLY FOR THE 953 00:36:22,741 --> 00:36:27,312 WHOLE HEALTH OF THOSE WITH 954 00:36:27,312 --> 00:36:29,047 ENDOMETRIOSIS ACROSS THEIR WHOLE 955 00:36:29,047 --> 00:36:29,248 LIVES. 956 00:36:29,248 --> 00:36:31,250 AGAIN THE CRITICAL WINDOW IS 957 00:36:31,250 --> 00:36:32,184 ACROSS THE LIFE COURSE. 958 00:36:32,184 --> 00:36:33,452 THERE ARE SO MANY NEW AND 959 00:36:33,452 --> 00:36:39,658 EXCITING ADVANCEMENTS I KNOW 960 00:36:39,658 --> 00:36:48,100 DR. ASSINNIE WILL TALK ABOUT AND 961 00:36:48,100 --> 00:36:51,603 I WANT TO REMIND THOSE HERE THAT 962 00:36:51,603 --> 00:36:54,539 THE NEXT MEETING HAS AN OPENING 963 00:36:54,539 --> 00:36:55,907 FOR ABSTRACT SUBMISSIONS NOW. 964 00:36:55,907 --> 00:36:58,577 WE'LL OCCUR IN MAY. 965 00:36:58,577 --> 00:37:01,880 THIS IS AN INTERNATIONAL MEETING 966 00:37:01,880 --> 00:37:02,948 EVERY TWO YEARS INCLUDING 967 00:37:02,948 --> 00:37:05,017 CLINICIANS, SCIENTISTS AND 968 00:37:05,017 --> 00:37:08,387 PATIENTS AND PATIENT ADVOCATES 969 00:37:08,387 --> 00:37:09,655 TO CONTINUE CUTTING-ONLY 970 00:37:09,655 --> 00:37:11,189 DISCOVERY FOR THOSE EXISTING 971 00:37:11,189 --> 00:37:13,325 WITH AND SURVIVING AND THRIVING 972 00:37:13,325 --> 00:37:13,759 WITH ENDOMETRIOSIS. 973 00:37:13,759 --> 00:37:23,935 THANK YOU. 974 00:37:25,604 --> 00:37:27,372 >> THANK YOU, STACEY. 975 00:37:27,372 --> 00:37:31,176 CAN I ASK YOU BRING UP YOUR 976 00:37:31,176 --> 00:37:31,743 DISCLOSURE SLIDE WHILE WE 977 00:37:31,743 --> 00:37:31,977 DISCUSS. 978 00:37:31,977 --> 00:37:33,445 I WANT IT SEE ALL THE GOOD WORK 979 00:37:33,445 --> 00:37:33,845 YOU DO. 980 00:37:33,845 --> 00:37:44,156 >> LET ME GO BACK. 981 00:38:03,241 --> 00:38:07,412 YOU DO A FANTASTIC JOB OF 982 00:38:07,412 --> 00:38:08,714 BRINGING ACROSS ENDOMETRIOSIS IS 983 00:38:08,714 --> 00:38:12,651 A WHOLE BODY CONDITION. 984 00:38:12,651 --> 00:38:16,755 NOT JUST GYNECOLOGIC. 985 00:38:16,755 --> 00:38:18,123 IT SEEMS LIKE THERE'S SOMEWHAT 986 00:38:18,123 --> 00:38:21,426 OF A MISUNDERSTANDING IN SOME 987 00:38:21,426 --> 00:38:22,027 CONTEXT THERE. 988 00:38:22,027 --> 00:38:24,329 >> SO, I THINK IT'S A BATTLE 989 00:38:24,329 --> 00:38:25,831 THAT NEEDS TO BE FOUGHT IN THAT. 990 00:38:25,831 --> 00:38:29,434 IF IT WERE STRICTLY A 991 00:38:29,434 --> 00:38:33,004 GYNECOLOGIC CONDITION AND WASN'T 992 00:38:33,004 --> 00:38:35,874 IMPACTING PEOPLE'S LIVES THE WAY 993 00:38:35,874 --> 00:38:37,075 IT IS DOESN'T CHANGE HOW 994 00:38:37,075 --> 00:38:39,077 IMPORTANT AND IMPACTFUL AND HOW 995 00:38:39,077 --> 00:38:40,345 MUCH WE NEED TO FIGHT FOR 996 00:38:40,345 --> 00:38:44,316 ATTENTION AND DISCOVERY AND 997 00:38:44,316 --> 00:38:46,518 INFECTION ON THE CONDITION. 998 00:38:46,518 --> 00:38:48,820 THE REALITY THAT IS BROADER ON 999 00:38:48,820 --> 00:38:51,590 THAT THIS, WE'RE HOPING THE 1000 00:38:51,590 --> 00:38:52,724 INFORMATION IT BRINGS MORE 1001 00:38:52,724 --> 00:38:54,559 INTEREST AND GREAT MINDS AND 1002 00:38:54,559 --> 00:39:00,966 DISCIPLINES TO THE TABLE BUT 1003 00:39:00,966 --> 00:39:03,902 ALSO GIVES PEOPLE WITH 1004 00:39:03,902 --> 00:39:06,138 ENDOMETRIOSIS A GREATER POINT OF 1005 00:39:06,138 --> 00:39:08,507 CONNECTION WITH THE HEALTH CARE 1006 00:39:08,507 --> 00:39:10,509 SYSTEM AND POTENTIALLY AGAIN 1007 00:39:10,509 --> 00:39:12,644 MAXIMIZING THEIR FULL WELLNESS 1008 00:39:12,644 --> 00:39:13,779 ACROSS THEIR WHOLE LIVES. 1009 00:39:13,779 --> 00:39:15,447 THAT IS CRITICAL. 1010 00:39:15,447 --> 00:39:18,683 AND I THINK THIS ALSO HIGHLIGHTS 1011 00:39:18,683 --> 00:39:24,556 THE LACK OF CURIOSITY WE HAVE 1012 00:39:24,556 --> 00:39:27,025 ACCEPTED FOR FEMALE-SPECIFIC 1013 00:39:27,025 --> 00:39:29,394 CONDITIONS AND THAT THEY HAVE, 1014 00:39:29,394 --> 00:39:31,563 UNFORTUNATELY, RECEIVED LESS 1015 00:39:31,563 --> 00:39:33,432 ATTENTION AND LESS INTEREST FROM 1016 00:39:33,432 --> 00:39:36,034 THE BROADER FIELD AND 1017 00:39:36,034 --> 00:39:38,036 DISCIPLINES AND THAT'S 1018 00:39:38,036 --> 00:39:39,171 ABSOLUTELY ESSENTIAL. 1019 00:39:39,171 --> 00:39:42,007 THE FACT IT IS RELATED TO MANY 1020 00:39:42,007 --> 00:39:45,444 MANY HEALTH SYSTEMS, MANY 1021 00:39:45,444 --> 00:39:47,279 BIOLOGICAL PATHWAYS HELPS 1022 00:39:47,279 --> 00:39:48,580 INCREASE THE CURIOSITY INTEREST 1023 00:39:48,580 --> 00:39:49,448 AND FOCUS ON PEOPLE WITH 1024 00:39:49,448 --> 00:39:51,283 ENDOMETRIOSIS IT'S A WIN FOR 1025 00:39:51,283 --> 00:39:51,683 EVERYONE. 1026 00:39:51,683 --> 00:39:53,084 >> FANTASTIC. 1027 00:39:53,084 --> 00:39:53,718 THANK YOU SO MUCH. 1028 00:39:53,718 --> 00:39:54,853 THERE'S REALLY GOOD QUESTIONS IN 1029 00:39:54,853 --> 00:39:56,922 THE CHAT I WANT TO GET TO BUT I 1030 00:39:56,922 --> 00:39:59,224 WANT TO GIVE IT TO OUR PANEL 1031 00:39:59,224 --> 00:39:59,524 OVER ALL. 1032 00:39:59,524 --> 00:40:00,592 I'LL BRING YOU BACK AT THE END 1033 00:40:00,592 --> 00:40:02,260 TO TALK THROUGH SOME OF THE 1034 00:40:02,260 --> 00:40:02,527 QUESTIONS. 1035 00:40:02,527 --> 00:40:03,795 >> THANK YOU. 1036 00:40:03,795 --> 00:40:06,631 >> THANK YOU, STACEY. 1037 00:40:06,631 --> 00:40:11,636 SO WE'LL MOVE NEXT TO DR. SUSIE 1038 00:40:11,636 --> 00:40:17,209 ASSANIE TALKING ABOUT AND A HALF 1039 00:40:17,209 --> 00:40:17,542 FW 1040 00:40:17,542 --> 00:40:19,611 -- NAVIGATING ENDOMETRIOSIS 1041 00:40:19,611 --> 00:40:21,012 COMPLEXITIES IN NAVIGATING LIFE. 1042 00:40:21,012 --> 00:40:24,015 >> IT'S AN HONOR TO BE HERE AND 1043 00:40:24,015 --> 00:40:25,083 TO BE INCLUDED IN THE PANEL. 1044 00:40:25,083 --> 00:40:29,421 I'M GOING TO FOCUS SPECIFICALLY 1045 00:40:29,421 --> 00:40:33,458 ON EVALUATION AND MANAGEMENT OF 1046 00:40:33,458 --> 00:40:39,431 PAIN AND THE MORE MODERN OF PAIN 1047 00:40:39,431 --> 00:40:40,765 MECHANISMS IN PATIENTS WITH 1048 00:40:40,765 --> 00:40:41,099 ENDOMETRIOSIS. 1049 00:40:41,099 --> 00:40:43,568 I WANT TO ECHO WHAT CANDACE SAID 1050 00:40:43,568 --> 00:40:46,371 AND WHILE I MAY USE THE WORD 1051 00:40:46,371 --> 00:40:49,007 WOMEN OUT OF EASE AND FLOW FOR 1052 00:40:49,007 --> 00:40:52,611 THE TALK, ENDOMETRIOSIS IS A 1053 00:40:52,611 --> 00:40:54,412 CONDITION THAT CAN AFFECT ANY 1054 00:40:54,412 --> 00:40:57,282 PERSON BORN WITH A UTERUS AND 1055 00:40:57,282 --> 00:41:01,086 CAN AN ACTIVE DISEASE EVEN WHEN 1056 00:41:01,086 --> 00:41:02,854 TAKING TESTOSTERONE AND OTHER 1057 00:41:02,854 --> 00:41:03,688 HORMONE MANAGEMENT IN THE BINARY 1058 00:41:03,688 --> 00:41:06,925 POPULATION. 1059 00:41:06,925 --> 00:41:11,162 SO THESE ARE MY DISCLOSURES. 1060 00:41:11,162 --> 00:41:13,231 DIANA GAVE A NICE AND 1061 00:41:13,231 --> 00:41:15,667 BEAUTIFULLY ARTICULATED SUMMARY 1062 00:41:15,667 --> 00:41:17,402 OF THE IMPACT THAT ENDOMETRIOSIS 1063 00:41:17,402 --> 00:41:19,237 CAN HAVE ON PATIENTS WHO SUFFER 1064 00:41:19,237 --> 00:41:20,605 FROM THE CONDITION. 1065 00:41:20,605 --> 00:41:22,941 I'M GOING TO NOT REVIEW THAT BUT 1066 00:41:22,941 --> 00:41:25,443 JUST DIVE STRAIGHT INTO THE 1067 00:41:25,443 --> 00:41:26,845 OBJECTIVES PER MY TALK. 1068 00:41:26,845 --> 00:41:28,346 I'LL FIRST DISCUSS THE 1069 00:41:28,346 --> 00:41:29,447 VARIABILITY IN THE CLINICAL 1070 00:41:29,447 --> 00:41:31,683 PRESENTATION OF PATIENTS WITH 1071 00:41:31,683 --> 00:41:32,017 ENDOMETRIOSIS. 1072 00:41:32,017 --> 00:41:34,352 THEN REVIEW THE MECHANISMS THAT 1073 00:41:34,352 --> 00:41:38,723 CAN LEAD TO CHRONIC PAIN WITH A 1074 00:41:38,723 --> 00:41:40,892 PARTICULAR EMPHASIS CALLED ON 1075 00:41:40,892 --> 00:41:42,294 NOCIPLASTIC PAIN DISORDERS AND 1076 00:41:42,294 --> 00:41:44,462 UNDERSTANDING AND IDENTIFYING 1077 00:41:44,462 --> 00:41:47,499 PAIN MECHANISMS IN THE TREATMENT 1078 00:41:47,499 --> 00:41:48,300 OF PATIENTS WITH ENDOMETRIOSIS 1079 00:41:48,300 --> 00:41:51,636 WITH THE GOAL OF ENHANCING 1080 00:41:51,636 --> 00:41:52,704 PATIENT CARE. 1081 00:41:52,704 --> 00:41:54,906 THE CARDINAL SYMPTOM OF 1082 00:41:54,906 --> 00:41:57,275 ENDOMETRIOSIS AS OTHERS HAVE 1083 00:41:57,275 --> 00:41:59,411 ALLUDED TO IS IT'S PELVIC PAIN. 1084 00:41:59,411 --> 00:42:05,116 APPROXIMATELY 70% OF PATIENTS 1085 00:42:05,116 --> 00:42:09,120 WITH ENDOMETRIOSIS EXPERIENCE 1086 00:42:09,120 --> 00:42:12,390 PELVIC PAIN AND DYSMENORRHEA 1087 00:42:12,390 --> 00:42:18,863 PAIN WIN PERIODS AND PAIN WITH 1088 00:42:18,863 --> 00:42:24,536 VAGINAL PENETRATION. 1089 00:42:24,536 --> 00:42:26,771 AND YOU CAN HAVE CONSTIPATION 1090 00:42:26,771 --> 00:42:29,007 AND BLOATING AND A THIRD CAN 1091 00:42:29,007 --> 00:42:30,942 HAVE INFERTILITY AND A THIRD CAN 1092 00:42:30,942 --> 00:42:32,243 HAVE PAIN WITH BOWEL MOVEMENT. 1093 00:42:32,243 --> 00:42:35,547 ABOUT 20% OF PATIENTS WITH 1094 00:42:35,547 --> 00:42:36,381 ENDOMETRIOSIS PRESENT WITH THE 1095 00:42:36,381 --> 00:42:38,283 FIRST SYMPTOM OF BEING AN 1096 00:42:38,283 --> 00:42:48,760 OVARIAN MASS AND PAIN WITH 1097 00:42:51,363 --> 00:42:51,563 URINATION. 1098 00:42:51,563 --> 00:42:53,431 AND IMPORTANT TO UNDERSTAND AS 1099 00:42:53,431 --> 00:42:59,671 RAY CLINIC A CLINICIAN IS A CON. 1100 00:42:59,671 --> 00:43:01,906 THOSE THAT HAVE ALL THREE, 1101 00:43:01,906 --> 00:43:12,417 PELVIC PAIN, DYSMENORRHEA AND 1102 00:43:12,684 --> 00:43:15,654 DYSPAREUNIA AND EVERY 1103 00:43:15,654 --> 00:43:22,594 COMBINATION EXISTS. 1104 00:43:22,594 --> 00:43:26,798 AND WHEN YOU LOOK AT THE PAIN 1105 00:43:26,798 --> 00:43:29,434 THREES A WIDE VARIATION IN THE 1106 00:43:29,434 --> 00:43:30,368 EXTENT OF DISEASE WE SEE. 1107 00:43:30,368 --> 00:43:35,440 IN THE PICTURE ON THE LEFT IS A 1108 00:43:35,440 --> 00:43:37,876 PICTURE OF STAGE 1 OR 1109 00:43:37,876 --> 00:43:38,943 SUPERFICIAL ENDOMETRIOSIS THAT 1110 00:43:38,943 --> 00:43:40,779 AFFECTS THE LIGAMENTS BEHIND THE 1111 00:43:40,779 --> 00:43:45,417 UTE 1112 00:43:45,417 --> 00:43:45,784 UTERUS. 1113 00:43:45,784 --> 00:43:50,455 THE MIDDLE IS STAGE 2 AND 3 AND 1114 00:43:50,455 --> 00:43:56,561 THE STRUCTURES ARE THE OVARIES 1115 00:43:56,561 --> 00:43:59,497 AND FALLOPIAN TUBES COME CLOSE 1116 00:43:59,497 --> 00:44:00,532 AND YOU SEE SCARRING IN THE 1117 00:44:00,532 --> 00:44:00,765 AREA. 1118 00:44:00,765 --> 00:44:04,469 THIS IS AN EXAMPLE OF A PATIENT 1119 00:44:04,469 --> 00:44:05,270 WITH STAGE 4 ENDOMETRIOSIS. 1120 00:44:05,270 --> 00:44:09,641 YOU CAN'T SEE ALL THE ANATOMY 1121 00:44:09,641 --> 00:44:15,146 WITHOUT LOOKING AT A VIDEO. 1122 00:44:15,146 --> 00:44:25,690 AND YOU CAN SEE THE BACK AND YOU 1123 00:44:27,992 --> 00:44:30,562 SEE THE ANATOMIC DISEASE TO MORE 1124 00:44:30,562 --> 00:44:31,963 SEVERE DISEASE THE SYSTEM 1125 00:44:31,963 --> 00:44:33,565 PROFILE SHOULD OFTEN MATCH THAT 1126 00:44:33,565 --> 00:44:36,534 AND SO LOGIC WOULD HAVE IT THE 1127 00:44:36,534 --> 00:44:37,635 PATIENT WOULD HAVE THE LEAST 1128 00:44:37,635 --> 00:44:39,170 AMOUNT AND THE LOWEST FREQUENCY 1129 00:44:39,170 --> 00:44:41,372 OF PAIN WHEREAS THE PATIENT WITH 1130 00:44:41,372 --> 00:44:43,775 THE MOST SEVERE SCAR TISSUE THE 1131 00:44:43,775 --> 00:44:45,677 BIGGEST ANATOMIC BURDEN OF 1132 00:44:45,677 --> 00:44:47,545 ENDOMETRIOSIS WOULD HAVE THE 1133 00:44:47,545 --> 00:44:49,013 MOST SEVERE PAIN. 1134 00:44:49,013 --> 00:44:51,015 BUT AS ANY PATIENT AS WELL AS 1135 00:44:51,015 --> 00:44:56,020 ANY CLINICIAN THAT SEES PATIENTS 1136 00:44:56,020 --> 00:44:58,456 WITH ENDOMETRIOSIS KNOWS ANY 1137 00:44:58,456 --> 00:44:59,791 COMBINATION IS POSSIBLE AND NOT 1138 00:44:59,791 --> 00:45:02,527 UNCOMMON FOR PATIENTS WITH 1139 00:45:02,527 --> 00:45:03,661 MINIMAL BURDEN OF DISEASE TO 1140 00:45:03,661 --> 00:45:05,563 HAVE SEVERE LIFE-IMPACTING PAIN 1141 00:45:05,563 --> 00:45:08,533 AND WE HAVE SEEN AS CLINICIANS 1142 00:45:08,533 --> 00:45:10,802 PATIENTS WHO HAVE QUITE SEVERE 1143 00:45:10,802 --> 00:45:11,603 ENDOMETRIOSIS BUT HAVE LITTLE TO 1144 00:45:11,603 --> 00:45:13,538 NO PAIN AT ALL. 1145 00:45:13,538 --> 00:45:16,574 TO ADD TO THE COMPLEXITY 1146 00:45:16,574 --> 00:45:17,942 HORMONAL TREATMENT WHICH ARE THE 1147 00:45:17,942 --> 00:45:21,246 GOLD STANDARD TREATMENT 1148 00:45:21,246 --> 00:45:22,313 THERAPIES TEND TO BE EFFECTIVE 1149 00:45:22,313 --> 00:45:23,815 IN THE MAJORITY OF PATIENTS BUT 1150 00:45:23,815 --> 00:45:25,350 NOT ALL. 1151 00:45:25,350 --> 00:45:27,652 70% OF PATIENTS TREATED WITH 1152 00:45:27,652 --> 00:45:29,354 HORMONE THERAPY FIND IMPROVEMENT 1153 00:45:29,354 --> 00:45:34,893 IN THEIR SYSTEMS AND 70% WHO 1154 00:45:34,893 --> 00:45:37,228 HAVE SURGICAL EXCISION HAVE 1155 00:45:37,228 --> 00:45:37,862 IMPROVEMENT. 1156 00:45:37,862 --> 00:45:39,164 THIS SEEMS TO BE CONSISTENT 1157 00:45:39,164 --> 00:45:45,804 IRRECTI IIVE -- IRRESPECTIVE O 1158 00:45:45,804 --> 00:45:46,337 THE DISEASE. 1159 00:45:46,337 --> 00:45:49,440 WHY IS THE CARE CHALLENGING AND 1160 00:45:49,440 --> 00:45:52,710 I ARGUE INSUFFICIENT. 1161 00:45:52,710 --> 00:45:54,779 WE NEED TO BETTER UNDERSTAND WHY 1162 00:45:54,779 --> 00:45:56,381 PATIENTS EXPERIENCE PAIN AND HOW 1163 00:45:56,381 --> 00:45:59,484 IS IT ENDOMETRIOSIS CAN 1164 00:45:59,484 --> 00:46:00,919 CONTRIBUTE TO PAIN? 1165 00:46:00,919 --> 00:46:04,022 SO THE MOST PROMINENT SYMPTOM IS 1166 00:46:04,022 --> 00:46:05,890 THAT OF PELVIC PAIN. 1167 00:46:05,890 --> 00:46:08,626 THE TRADITIONAL AND MOST WILDLY 1168 00:46:08,626 --> 00:46:13,731 HELD VIEW IS ENDOMETRIOSIS IS A 1169 00:46:13,731 --> 00:46:14,732 NOCICEPTIVE PAIN CONDITION THAT 1170 00:46:14,732 --> 00:46:18,002 OCCURS DUE TO THE ACTIVATION OF 1171 00:46:18,002 --> 00:46:21,439 LESIONS OF PERIPHERAL NERVES 1172 00:46:21,439 --> 00:46:22,674 THROUGH MECHANISMS OF 1173 00:46:22,674 --> 00:46:24,809 INFLAMMATION AND INCREASED NERVE 1174 00:46:24,809 --> 00:46:26,211 FIBERS THROUGH THE SPINAL CORD 1175 00:46:26,211 --> 00:46:27,679 UP TO THE BRAIN AND YOU 1176 00:46:27,679 --> 00:46:28,279 EXPERIENCE PAIN. 1177 00:46:28,279 --> 00:46:31,082 AND THE OVERWHELMING RESEARCH TO 1178 00:46:31,082 --> 00:46:33,751 DATE HAS FOCUSSED ON MECHANISMS 1179 00:46:33,751 --> 00:46:40,892 BY WHICH WE CAN SUPPRESS THE 1180 00:46:40,892 --> 00:46:42,427 LESIONS AND PAIN IMPROVEMENTS IN 1181 00:46:42,427 --> 00:46:45,864 THE VAST MAJORITY OF PATIENT 1182 00:46:45,864 --> 00:46:46,431 MZS. 1183 00:46:46,431 --> 00:46:48,132 WE KNOW IT'S NOT SUFFICIENT TO 1184 00:46:48,132 --> 00:46:49,801 EXPLAIN ALL PATIENTS WITH THE 1185 00:46:49,801 --> 00:46:50,435 CONDITION. 1186 00:46:50,435 --> 00:46:53,705 SO MODERN UNDERSTANDING OF PAIN 1187 00:46:53,705 --> 00:46:55,273 MECHANISMS HELPS US TO 1188 00:46:55,273 --> 00:46:57,442 UNDERSTAND THAT THE PAIN IS 1189 00:46:57,442 --> 00:46:59,010 ACTUALLY AN OUTPUT OF THE BRAIN. 1190 00:46:59,010 --> 00:47:00,612 SO THE BRAIN HAS A POWERFUL 1191 00:47:00,612 --> 00:47:02,313 ABILITY TO EITHER AMPLIFY THE 1192 00:47:02,313 --> 00:47:06,050 SIGNAL THAT IS COMING FROM THE 1193 00:47:06,050 --> 00:47:07,652 PERIPHERY AS WELL AS DAMPEN 1194 00:47:07,652 --> 00:47:08,987 SIGNAL COMING FROM THE 1195 00:47:08,987 --> 00:47:09,254 PERIPHERY. 1196 00:47:09,254 --> 00:47:11,289 THE PAIN ANY GIVEN PERSON 1197 00:47:11,289 --> 00:47:13,258 EXPERIENCES ISN'T JUST ABOUT 1198 00:47:13,258 --> 00:47:13,925 WHAT'S COMING IN FROM THE 1199 00:47:13,925 --> 00:47:15,693 OUTSIDE OF THE BODY TO THE BRAIN 1200 00:47:15,693 --> 00:47:19,163 BUT ACTUALLY AN OUTPUT OF THE 1201 00:47:19,163 --> 00:47:19,364 BRAIN. 1202 00:47:19,364 --> 00:47:20,865 AND PAIN IS THE BALANCE BETWEEN 1203 00:47:20,865 --> 00:47:21,966 WHAT'S COMING IN AND WHAT THE 1204 00:47:21,966 --> 00:47:24,002 BRAIN DOES TO TURN UP THE SIGNAL 1205 00:47:24,002 --> 00:47:25,069 OR TURN DOWN THE SIGNAL. 1206 00:47:25,069 --> 00:47:28,706 AND WHAT WE KNOW NOW IS THAT 1207 00:47:28,706 --> 00:47:30,942 THERE'S MANY CONDITIONS IN WHICH 1208 00:47:30,942 --> 00:47:32,243 THE CENTRAL NERVOUS SYSTEM PLAYS 1209 00:47:32,243 --> 00:47:34,379 A VERY IMPORTANT ROLE IN 1210 00:47:34,379 --> 00:47:39,651 AUGMENTING AND MAINTAINING THE 1211 00:47:39,651 --> 00:47:40,051 PAIN EXPERIENCE. 1212 00:47:40,051 --> 00:47:43,688 MORE MODERN TERMINOLOGY IS THE 1213 00:47:43,688 --> 00:47:46,491 CONDITIONS ARE REFERRED TO AS 1214 00:47:46,491 --> 00:47:47,892 NOCIPLASTIC PAIN CONDITIONS 1215 00:47:47,892 --> 00:47:50,595 WHERE THE PAIN IS AMPLIFIED 1216 00:47:50,595 --> 00:47:52,997 BEYOND WHAT IS TYPICALLY 1217 00:47:52,997 --> 00:47:56,534 EXPECTED FROM THE SIGNAL. 1218 00:47:56,534 --> 00:48:00,538 AND THERE'S MANY PAIN SIGNALS. 1219 00:48:00,538 --> 00:48:02,540 FIBROMYALGIA IS A CLASSIC 1220 00:48:02,540 --> 00:48:04,409 EXAMPLE OF A NOCIPLASTIC 1221 00:48:04,409 --> 00:48:06,144 SYMPTOM. 1222 00:48:06,144 --> 00:48:07,512 THESE CONDITIONS ARE OFTEN 1223 00:48:07,512 --> 00:48:08,446 CHARACTERIZED BY WIDESPREAD 1224 00:48:08,446 --> 00:48:08,713 PAIN. 1225 00:48:08,713 --> 00:48:11,049 THE PAIN OFTEN PERSISTS EVEN 1226 00:48:11,049 --> 00:48:13,217 WHEN THE ORIGINAL SIGNAL FROM 1227 00:48:13,217 --> 00:48:13,885 THE BODY HEALS. 1228 00:48:13,885 --> 00:48:16,254 THE PAIN SEVERITY IS OUT OF 1229 00:48:16,254 --> 00:48:18,056 PROPORTION TO THE PATHOLOGY AND 1230 00:48:18,056 --> 00:48:20,158 IN THE PATIENTS WITH NOCIPLASTIC 1231 00:48:20,158 --> 00:48:22,193 PAIN CONDITIONS TEND TO HAVE A 1232 00:48:22,193 --> 00:48:23,494 HIGHER LIFE TIME OF HISTORY OF 1233 00:48:23,494 --> 00:48:25,430 PAIN THROUGHOUT THE BODY AND 1234 00:48:25,430 --> 00:48:29,767 MORE COMMON IN FEMALES COMPARED 1235 00:48:29,767 --> 00:48:32,170 TO MALES AND THE PAIN IS 1236 00:48:32,170 --> 00:48:33,671 EXACERBATED BY STRESSORS. 1237 00:48:33,671 --> 00:48:35,073 IT'S CRITICAL TO UNDERSTAND 1238 00:48:35,073 --> 00:48:38,343 THESE ARE NOT JUST PAIN 1239 00:48:38,343 --> 00:48:40,878 DISORDERS BUT THE CARDINAL 1240 00:48:40,878 --> 00:48:44,716 SYMPTOMS OF NOCIPLASTIC PAIN 1241 00:48:44,716 --> 00:48:47,251 INCLUDE SYMPTOMS LIKE INCREASED 1242 00:48:47,251 --> 00:48:51,522 GENERAL SENSITIVITY TO INTERNAL 1243 00:48:51,522 --> 00:48:54,425 SENSATIONS AND STIMULI AND 1244 00:48:54,425 --> 00:48:56,427 NOCIPLASTIC PAIN CONDITIONS ARE 1245 00:48:56,427 --> 00:48:59,998 ASSOCIATED WITH HIGH LEVELS OF 1246 00:48:59,998 --> 00:49:02,500 FATIGUE AND POOR SLEEP AND 1247 00:49:02,500 --> 00:49:03,668 CONCENTRATION AND SHORT TERM 1248 00:49:03,668 --> 00:49:06,137 MEMORY DIFFICULTIES AND HIGHER 1249 00:49:06,137 --> 00:49:07,138 PREPONDERANCE FOR MOOD DISORDERS 1250 00:49:07,138 --> 00:49:09,640 SUCH AS ANXIETY AND DEPRESSION. 1251 00:49:09,640 --> 00:49:12,877 WHAT DO WE KNOW ABOUT 1252 00:49:12,877 --> 00:49:13,578 ENDOMETRIOSIS PELVIC PAIN AS 1253 00:49:13,578 --> 00:49:14,545 WELL AS THE BRAIN? 1254 00:49:14,545 --> 00:49:16,881 AND WHY SHOULD IT MATTER TO 1255 00:49:16,881 --> 00:49:17,915 PATIENTS AS WELL AS PHYSICIANS 1256 00:49:17,915 --> 00:49:21,419 LIKE ME? 1257 00:49:21,419 --> 00:49:22,320 WE KNOW PATIENTS WITH 1258 00:49:22,320 --> 00:49:23,654 ENDOMETRIOSIS AND CHRONIC PELVIC 1259 00:49:23,654 --> 00:49:25,223 PAIN DEMONSTRATE MANY 1260 00:49:25,223 --> 00:49:26,290 EXPERIMENTAL PAIN AND 1261 00:49:26,290 --> 00:49:28,960 NEUROIMAGING FINDINGS WE SEE IN 1262 00:49:28,960 --> 00:49:30,862 OTHER NOCIPLASTIC PAIN 1263 00:49:30,862 --> 00:49:31,162 CONDITIONS. 1264 00:49:31,162 --> 00:49:32,897 INCREASED SENSITIVITY OF PAIN 1265 00:49:32,897 --> 00:49:34,932 AND SENSORY STIMULI AND CHANGES 1266 00:49:34,932 --> 00:49:36,701 IN BRAIN STRUCTURE AND BRAIN 1267 00:49:36,701 --> 00:49:43,141 FUNCTION AND THE CHANGES WE SEE 1268 00:49:43,141 --> 00:49:45,410 ARE INDEPENDENT OF THE SEVERITY 1269 00:49:45,410 --> 00:49:48,880 OF ENDOMETRIOSIS AND SEE THIS IN 1270 00:49:48,880 --> 00:49:51,315 PATIENTS WITH CHRONIC PAIN WITH 1271 00:49:51,315 --> 00:49:52,850 AND WITHOUT ENDOMETRIOSIS 1272 00:49:52,850 --> 00:49:56,154 IRRESPECTIVE OF THE SEVERITY OF 1273 00:49:56,154 --> 00:49:56,754 ENDO. 1274 00:49:56,754 --> 00:49:59,557 WE DON'T SEE IT IN THOSE WITH 1275 00:49:59,557 --> 00:50:00,391 PAIN FREE ENDOMETRIOSIS. 1276 00:50:00,391 --> 00:50:03,227 WHEN YOU LOOK AT THE LESS COMMON 1277 00:50:03,227 --> 00:50:07,231 SUB CATEGORY OF PATIENTS WITH 1278 00:50:07,231 --> 00:50:07,932 PAIN-FREE ENDOMETRIOSIS WE HAVE 1279 00:50:07,932 --> 00:50:11,602 A DIFFERENT FINDING WHERE WE SEE 1280 00:50:11,602 --> 00:50:13,438 INCREASED GRAY MATTER VOLUME OF 1281 00:50:13,438 --> 00:50:17,575 THE PERIAQUEDUCTAL GRAY INVOLVED 1282 00:50:17,575 --> 00:50:20,144 IN DESCENDING THE PAIN OR THE 1283 00:50:20,144 --> 00:50:21,579 BRAIN'S ABILITY TO TURN DOWN THE 1284 00:50:21,579 --> 00:50:23,381 PAIN SIGNAL FROM THE PERIPHERY. 1285 00:50:23,381 --> 00:50:24,816 IT'S POSSIBLE THE ADAPTIVE 1286 00:50:24,816 --> 00:50:26,184 CHANGES IN THE BRAIN PLAY BE ONE 1287 00:50:26,184 --> 00:50:31,823 OF THE MECHANISMS BY WHICH THESE 1288 00:50:31,823 --> 00:50:35,026 PATIENTS OFFSET PERIPHERAL 1289 00:50:35,026 --> 00:50:36,394 NOCICEPTIVE INPUT? 1290 00:50:36,394 --> 00:50:37,929 WHY DOES THIS MATTER? 1291 00:50:37,929 --> 00:50:40,264 HAVE NOCIPLASTIC PAIN IS A RISK 1292 00:50:40,264 --> 00:50:44,335 FACTOR FOR DEVELOPING PERSISTENT 1293 00:50:44,335 --> 00:50:47,371 PAIN AFTER SURGERY. 1294 00:50:47,371 --> 00:50:49,674 WE FOLLOWED PATIENTS UNDERGOING 1295 00:50:49,674 --> 00:50:51,642 HYSTERECTOMY FOR CHRONIC PELVIC 1296 00:50:51,642 --> 00:50:53,444 PAIN AND WE FOUND PRIOR TO 1297 00:50:53,444 --> 00:50:56,948 SURGERY IF A PATIENT HAD HIGHER 1298 00:50:56,948 --> 00:50:58,015 MARKERS OF NOCIPLASTIC PAIN THEY 1299 00:50:58,015 --> 00:51:02,120 WERE MORE LIKELY TO REPORT 1300 00:51:02,120 --> 00:51:04,655 PERSISTENT PAIN 6 MONTHS AFTER 1301 00:51:04,655 --> 00:51:06,524 SURGERY AND OTHER GROUP 1302 00:51:06,524 --> 00:51:08,860 INCLUDING PAUL YOUNG SHOWED 1303 00:51:08,860 --> 00:51:10,728 SIMILAR FINDINGS FOR THOSE 1304 00:51:10,728 --> 00:51:12,597 UNDERGOING SURGERY FOR 1305 00:51:12,597 --> 00:51:12,930 ENDOMETRIOSIS. 1306 00:51:12,930 --> 00:51:14,932 HOW CAN WE FIT THE PIECES 1307 00:51:14,932 --> 00:51:15,900 TOGETHER TO ENHANCE PATIENT CARE 1308 00:51:15,900 --> 00:51:17,502 AND QUALITY OF LIFE? 1309 00:51:17,502 --> 00:51:21,172 FIRST, AS OTHERS MENTIONED, THE 1310 00:51:21,172 --> 00:51:23,040 IMPACT OF ENDOMETRIOSIS ON 1311 00:51:23,040 --> 00:51:25,409 PATIENTS IN A LIFE, EDUCATION, 1312 00:51:25,409 --> 00:51:27,445 FAMILY, CAREER IS QUITE 1313 00:51:27,445 --> 00:51:27,745 SIGNIFICANT. 1314 00:51:27,745 --> 00:51:31,249 AND IN PATIENTS THAT HAVE 1315 00:51:31,249 --> 00:51:31,782 INADEQUATELY TREATED 1316 00:51:31,782 --> 00:51:33,417 ENDOMETRIOSIS THEIR LIFE COURSE 1317 00:51:33,417 --> 00:51:35,686 POTENTIAL CAN BE SUBSTANTIALLY 1318 00:51:35,686 --> 00:51:39,657 ALTERED BY SUFFERING FROM 1319 00:51:39,657 --> 00:51:41,359 CHRONIC PAIN AS WELL AS 1320 00:51:41,359 --> 00:51:42,393 INFERTILITY AND TO DIAGNOSIS 1321 00:51:42,393 --> 00:51:44,662 EARLY THE HOPE IS PATIENTS CAN 1322 00:51:44,662 --> 00:51:46,931 HAVE SIMILAR LIFE COURSE 1323 00:51:46,931 --> 00:51:49,433 ACHIEVEMENT TO THOSE WHO HAVE 1324 00:51:49,433 --> 00:51:50,835 NEVER EXPERIENCED ENDOMETRIOSIS. 1325 00:51:50,835 --> 00:51:53,004 I WOULD ALSO VENTURE TO GUESS IF 1326 00:51:53,004 --> 00:51:55,039 WE DIAGNOSIS AND TREAT EARLY WE 1327 00:51:55,039 --> 00:51:56,574 MIGHT ALSO BE ABLE TO INTERVENE 1328 00:51:56,574 --> 00:52:01,345 AT A TIME WHEN WE CAN PREVENT 1329 00:52:01,345 --> 00:52:05,216 TRANSITION TO CHRONIC PER SSISTT 1330 00:52:05,216 --> 00:52:06,684 AND NOCIPLASTIC PAIN. 1331 00:52:06,684 --> 00:52:09,921 THIS ABSTRACT WAS PRESENTED BY A 1332 00:52:09,921 --> 00:52:11,989 GROUP THAT LOOKED AT DURATION OF 1333 00:52:11,989 --> 00:52:15,660 PAIN SYSTEMS AND THOSE WHO HAD 1334 00:52:15,660 --> 00:52:19,830 LONGER DURATION OF PAIN HAD 1335 00:52:19,830 --> 00:52:23,434 GREATER FINDINGS CONNECTED WITH 1336 00:52:23,434 --> 00:52:24,569 NOCIPLASTIC PAIN. 1337 00:52:24,569 --> 00:52:25,303 FROM A CLINICAL PERSPECTIVE ONE 1338 00:52:25,303 --> 00:52:27,672 PAIN APPROACH IS TO ALWAYS TREAT 1339 00:52:27,672 --> 00:52:31,742 THE WHOLE PERSON, TO IDENTIFY 1340 00:52:31,742 --> 00:52:33,277 ALL THE POTENTIAL REASONS AN 1341 00:52:33,277 --> 00:52:34,946 INDIVIDUAL CAN BE EXPERIENCING 1342 00:52:34,946 --> 00:52:37,882 PAIN INCLUDING ENDOMETRIOSIS AND 1343 00:52:37,882 --> 00:52:38,783 THE OVERLAPPING PAIN CONDITIONS 1344 00:52:38,783 --> 00:52:41,419 AND WE NEED TO BEGIN WITH GOLD 1345 00:52:41,419 --> 00:52:43,287 STANDARD THERAPIES FOR ALL THE 1346 00:52:43,287 --> 00:52:45,389 CONTRIBUTES FACTORS AND IN 1347 00:52:45,389 --> 00:52:49,427 CONDITIONS LIKE ENDOMETRIOSIS, 1348 00:52:49,427 --> 00:52:51,128 HORMONAL SUPPRESSION AND 1349 00:52:51,128 --> 00:52:52,563 SURGICAL EXCISION ARE THE GOLD 1350 00:52:52,563 --> 00:52:55,499 STANDARDS AND LOOK AT THE 1351 00:52:55,499 --> 00:52:57,235 FACTORS AND TREAT THOSE AS WELL. 1352 00:52:57,235 --> 00:53:01,105 WE NEED TO REMEMBER ONE SIZE 1353 00:53:01,105 --> 00:53:01,772 DOES NOT FIT ALL. 1354 00:53:01,772 --> 00:53:02,340 CHRONIC PAIN INCLUDING 1355 00:53:02,340 --> 00:53:04,842 ENDOMETRIOSIS PAIN CAN ARISE 1356 00:53:04,842 --> 00:53:07,278 FROM ANY COMBINATION OF THESE 1357 00:53:07,278 --> 00:53:08,112 DIFFERENT MECHANISMS. 1358 00:53:08,112 --> 00:53:09,380 CHRONIC PAIN IS ASSOCIATED WITH 1359 00:53:09,380 --> 00:53:10,748 CHANGES IN PAIN SENSITIVITY THAT 1360 00:53:10,748 --> 00:53:14,619 CAN BE MEDIATED BY THE BRAIN AND 1361 00:53:14,619 --> 00:53:19,857 PATIENTS WITH NOCIPLASTIC PAIN 1362 00:53:19,857 --> 00:53:21,559 CAN BENEFIT FROM THE TREATMENT 1363 00:53:21,559 --> 00:53:22,560 OF ENDOMETRIOSIS LESIONS BUT THE 1364 00:53:22,560 --> 00:53:24,128 REASON MAY NOT BE THE SAME AS 1365 00:53:24,128 --> 00:53:26,631 THOSE WITHOUT THE CHANGES. 1366 00:53:26,631 --> 00:53:29,200 I WANT TO EMPHASIZE IT CAN TAKE 1367 00:53:29,200 --> 00:53:30,668 TIME TO FIND THE BEST 1368 00:53:30,668 --> 00:53:31,769 COMBINATION OF TREATMENTS AND 1369 00:53:31,769 --> 00:53:33,437 THIS MAY CHANGE OVER THE LIFE 1370 00:53:33,437 --> 00:53:34,805 COURSE DEPENDING ON THE 1371 00:53:34,805 --> 00:53:36,974 PATIENT'S GOALS AND PREFERENCES. 1372 00:53:36,974 --> 00:53:41,279 SO WHERE DO WE GO FROM HERE? 1373 00:53:41,279 --> 00:53:43,614 WE ABSOLUTELY NEED BETTER 1374 00:53:43,614 --> 00:53:44,815 DIAGNOSTICS AS WELL AS IMPROVE 1375 00:53:44,815 --> 00:53:46,851 THE KNOWLEDGE AND ACCESS TO 1376 00:53:46,851 --> 00:53:47,184 EXPERT CARE. 1377 00:53:47,184 --> 00:53:49,387 BUT MORE IMPORTANTLY, ONCE WE 1378 00:53:49,387 --> 00:53:51,555 HAVE THE DIAGNOSIS THAT'S NOT 1379 00:53:51,555 --> 00:53:54,759 ENOUGH OUR CURRENT TREATMENT 1380 00:53:54,759 --> 00:53:58,296 STRATEGIES ARE INSUFFICIENT AND 1381 00:53:58,296 --> 00:53:59,830 NOT PATIENT CENTERED NOR 1382 00:53:59,830 --> 00:54:01,799 PERSONALIZED TO THE UNDERLYING 1383 00:54:01,799 --> 00:54:02,366 MECHANISM. 1384 00:54:02,366 --> 00:54:04,135 WE NEED TO INVEST TIME AND MONEY 1385 00:54:04,135 --> 00:54:06,937 IN DEVELOPING INNOVATIVE 1386 00:54:06,937 --> 00:54:08,472 THERAPIES TO TREAT PAIN AND 1387 00:54:08,472 --> 00:54:10,841 REOCCURRENCE AND IDENTIFY THE 1388 00:54:10,841 --> 00:54:12,143 RIGHT TREATMENT FOR EACH PATIENT 1389 00:54:12,143 --> 00:54:14,178 BASED ON THE INDIVIDUAL'S 1390 00:54:14,178 --> 00:54:16,213 UNDERLYING PAIN MECHANISM SO 1391 00:54:16,213 --> 00:54:18,716 THEY'RE NOT GOING THROUGH 10, 1392 00:54:18,716 --> 00:54:20,418 15, 20 PLUS YEARS TRYING YOU 1393 00:54:20,418 --> 00:54:22,953 WILL MULTIPLE THINGS IN WILL 1394 00:54:22,953 --> 00:54:23,821 THEY FIND THE COMBINATION THAT 1395 00:54:23,821 --> 00:54:24,955 WORKS FOR THEM. 1396 00:54:24,955 --> 00:54:26,791 I HOPE I DIDN'T TAKE TOO MUCH 1397 00:54:26,791 --> 00:54:29,193 TIME AND WANT TO THANK NICHD FOR 1398 00:54:29,193 --> 00:54:29,760 THE FUNDING OPPORTUNITIES 1399 00:54:29,760 --> 00:54:32,730 THEY'VE GIVEN OUR TEAM AND HOPE 1400 00:54:32,730 --> 00:54:33,664 WE'LL CONTINUE TO GO DOWN THE 1401 00:54:33,664 --> 00:54:38,803 COURSE OF DISCOVERY. 1402 00:54:38,803 --> 00:54:41,105 >> THANK YOU, SO MUCH, SUSIE. 1403 00:54:41,105 --> 00:54:43,607 THERE ARE SO QUESTIONS WE'LL 1404 00:54:43,607 --> 00:54:47,678 ANSWER IN THE PANEL. 1405 00:54:47,678 --> 00:54:49,246 HYSTERECTOMY CAME UP A FEW TIMES 1406 00:54:49,246 --> 00:54:53,784 AND YOU COMMENTED AS WELL. 1407 00:54:53,784 --> 00:54:59,824 TALK ABOUT DIAGNOSING ENDO AFTER 1408 00:54:59,824 --> 00:55:01,525 HYSTERECTOMY AND HOW CURATIVE OR 1409 00:55:01,525 --> 00:55:03,661 NOT IT IS. 1410 00:55:03,661 --> 00:55:05,896 >> HYSTERECTOMY AS A TAKE HOME 1411 00:55:05,896 --> 00:55:09,300 MESSAGE I GIVE TO PATIENTS IS 1412 00:55:09,300 --> 00:55:12,503 IT'S NOT A CURE FOR 1413 00:55:12,503 --> 00:55:14,972 ENDOMETRIOSIS. 1414 00:55:14,972 --> 00:55:16,273 TYPICALLY WE KNOW THERE'S QUITE 1415 00:55:16,273 --> 00:55:17,708 A BIT OF MORBIDITY ASSOCIATED 1416 00:55:17,708 --> 00:55:21,245 WITH REMOVING THE OVARIES 1417 00:55:21,245 --> 00:55:26,050 ESPECIALLY IN PRE-MENOPAUSAL 1418 00:55:26,050 --> 00:55:27,485 OVARIES. 1419 00:55:27,485 --> 00:55:30,321 UNLESS THEY'RE SEVERELY INJURED 1420 00:55:30,321 --> 00:55:31,956 WITH LESIONS THE STANDARD OF 1421 00:55:31,956 --> 00:55:35,693 CARE IS TO AT LEAST LEAVE ONE 1422 00:55:35,693 --> 00:55:36,427 OVARY BEHIND. 1423 00:55:36,427 --> 00:55:40,664 IT'S EFFECTIVE IN ABOUT 75% OF 1424 00:55:40,664 --> 00:55:42,433 PATIENTS REPORT LONG TERM 1425 00:55:42,433 --> 00:55:45,403 IMPROVEMENT IN THEIR SYSTEMS 1426 00:55:45,403 --> 00:55:47,972 WITH A HYSTERECTOMY THAT DOES 1427 00:55:47,972 --> 00:55:49,707 NOT INCLUDE THE OVARIES. 1428 00:55:49,707 --> 00:55:52,843 BUT WHERE THEY'RE REMOVED THE 1429 00:55:52,843 --> 00:55:53,978 EFFICACY INCREASES CLOSER TO 90% 1430 00:55:53,978 --> 00:55:55,146 HOWEVER IT'S IMPORTANT TO KNOW 1431 00:55:55,146 --> 00:55:59,650 UP TO 10% OF PATIENTS EVEN WITH 1432 00:55:59,650 --> 00:56:01,652 HYSTERECTOMY AND OVARY REMOVAL 1433 00:56:01,652 --> 00:56:04,889 HAVE SOME DEGREE OF PERSISTENT 1434 00:56:04,889 --> 00:56:05,122 PAIN. 1435 00:56:05,122 --> 00:56:07,858 IT'S NOT SYNONYMOUS WITH 1436 00:56:07,858 --> 00:56:09,427 RECURRENT ENDOMETRIOSIS. 1437 00:56:09,427 --> 00:56:11,695 SOME HAVE NO EVIDENCE OF 1438 00:56:11,695 --> 00:56:12,997 RECURRENT ENDOMETRIOSIS DESPITE 1439 00:56:12,997 --> 00:56:14,765 HAVING PERSISTENT PAIN AND 1440 00:56:14,765 --> 00:56:16,434 THAT'S WHERE WE LOOK FOR OTHER 1441 00:56:16,434 --> 00:56:19,770 CAUSES OF UNDERLYING PAIN. 1442 00:56:19,770 --> 00:56:21,672 CURRENTLY OUR MOST LIKELY WAY WE 1443 00:56:21,672 --> 00:56:23,574 LOOK FOR RECURRENT ENDOMETRIOSIS 1444 00:56:23,574 --> 00:56:26,143 IS WITH SOME TYPE OF ADVANCED 1445 00:56:26,143 --> 00:56:28,446 IMAGING LIKE MRI WITH A CAVEAT 1446 00:56:28,446 --> 00:56:31,982 UNDERSTANDING THAT THIS DOESN'T 1447 00:56:31,982 --> 00:56:32,616 IDENTIFY SUPERFICIAL DISEASE AND 1448 00:56:32,616 --> 00:56:34,652 THIS IS DEFINITELY AN AREA THAT 1449 00:56:34,652 --> 00:56:38,856 NEEDS ACTIVE ENGAGEMENT. 1450 00:56:38,856 --> 00:56:39,623 >> THANK YOU SO MUCH. 1451 00:56:39,623 --> 00:56:42,960 THE CENTRAL POINT IN YOUR TALK 1452 00:56:42,960 --> 00:56:45,196 THAT ENDOMETRIOSIS CHANGES THE 1453 00:56:45,196 --> 00:56:47,531 BRAIN, THE PAIN ITSELF, THAT 1454 00:56:47,531 --> 00:56:49,433 PAIN CHANGES YOUR BRAIN I THINK 1455 00:56:49,433 --> 00:56:51,335 IS SOMETHING THAT HAS SO MANY 1456 00:56:51,335 --> 00:56:52,903 REPERCUSSIONS FOR HOW WE'RE 1457 00:56:52,903 --> 00:56:54,271 TREATED AND HOW WE'RE ASKED TO 1458 00:56:54,271 --> 00:56:58,809 BE TREATED. 1459 00:56:58,809 --> 00:57:04,381 >> ABSOLUTELY. 1460 00:57:04,381 --> 00:57:06,116 SO FOR OUR LAST SPEAKER WE 1461 00:57:06,116 --> 00:57:08,986 WANTED TO TRY TO SHOWCASE THE 1462 00:57:08,986 --> 00:57:10,187 COOL RESEARCH NIH DOES SUPPORT 1463 00:57:10,187 --> 00:57:11,655 ON BEHALF OF THE AMERICAN 1464 00:57:11,655 --> 00:57:12,089 PUBLIC. 1465 00:57:12,089 --> 00:57:12,923 SOME OF THE WAYS WE ARE TRYING 1466 00:57:12,923 --> 00:57:15,526 TO DRIVE THE SCIENCE FORWARD AND 1467 00:57:15,526 --> 00:57:18,429 TAKE ADVANCES FROM OTHER FIELDS 1468 00:57:18,429 --> 00:57:21,632 AND BRING THEM TO GYNECOLOGY AND 1469 00:57:21,632 --> 00:57:23,434 WOMEN'S HEALTH. 1470 00:57:23,434 --> 00:57:27,671 ONE GREAT EXAMPLE IS NEXT GEN 1471 00:57:27,671 --> 00:57:29,940 JANE LED BY RIDHI TARIYAL GOING 1472 00:57:29,940 --> 00:57:31,842 TO TALK TO US ABOUT HER COMPANY 1473 00:57:31,842 --> 00:57:33,310 AND WHAT THEY'RE DOING TO DECODE 1474 00:57:33,310 --> 00:57:35,846 THE LANGUAGE OF UTERINE HEALTH. 1475 00:57:35,846 --> 00:57:37,314 >> THANK YOU, CANDACE. 1476 00:57:37,314 --> 00:57:38,649 I DON'T THINK I'M SHARING MY 1477 00:57:38,649 --> 00:57:39,817 SLIDES. 1478 00:57:39,817 --> 00:57:42,052 AMY IS. 1479 00:57:42,052 --> 00:57:42,286 PERFECT. 1480 00:57:42,286 --> 00:57:43,521 NEXT SLIDE MOVING FORWARD. 1481 00:57:43,521 --> 00:57:46,924 IT'S A PLEASURE TO FOLLOW ON THE 1482 00:57:46,924 --> 00:57:48,792 HEELS OF THIS POWERFUL GROUP AND 1483 00:57:48,792 --> 00:57:50,628 THESE EXPERTS HAVE GIVEN A 1484 00:57:50,628 --> 00:57:53,430 FOUNDATION OF THE LIVED JOURNEY 1485 00:57:53,430 --> 00:58:02,473 AND EPIDEMIOLOGY AND TREATMENT 1486 00:58:02,473 --> 00:58:05,376 AND WE SPENT YEARS BUILDING A 1487 00:58:05,376 --> 00:58:06,710 MENSTRUAL DATA PLATFORM. 1488 00:58:06,710 --> 00:58:08,212 I'LL START BY THANKING NICHD FOR 1489 00:58:08,212 --> 00:58:09,680 THEIR GENEROUS SUPPORT OF THEIR 1490 00:58:09,680 --> 00:58:10,347 WORK. 1491 00:58:10,347 --> 00:58:17,054 THERE WAS AND IS A DEARTH 6 OF 1492 00:58:17,054 --> 00:58:19,156 INFORMATION ON THE DATA AND 1493 00:58:19,156 --> 00:58:21,425 EFFORTS AND FUNDING TO CLOSE THE 1494 00:58:21,425 --> 00:58:26,063 GAP BY GENOMICALLY PROFILING 1495 00:58:26,063 --> 00:58:29,433 SHED EPITHELIUM HOPE TO IMPACT 1496 00:58:29,433 --> 00:58:33,470 HOW DISEASES SHOW UP IN OUR 1497 00:58:33,470 --> 00:58:41,211 MENSTRUAL CYCLES. 1498 00:58:41,211 --> 00:58:44,214 THERE ARE TWO OPPORTUNITIES 1499 00:58:44,214 --> 00:58:44,848 LOOKING AT MENSTRUAL BLOOD. 1500 00:58:44,848 --> 00:58:48,953 YOU CAN LOOK FOR THE ABSENCE OR 1501 00:58:48,953 --> 00:58:50,254 PRESENCE OF A SIGNAL THAT'S 1502 00:58:50,254 --> 00:58:52,756 PATHOGENIC AND LOOKING FOR A 1503 00:58:52,756 --> 00:58:54,625 LOCAL INFECTION CAUSED BY A 1504 00:58:54,625 --> 00:58:55,359 VIRUS OR BACTERIA. 1505 00:58:55,359 --> 00:58:57,428 SOMETHING PROFOUND AND WHAT WE 1506 00:58:57,428 --> 00:59:00,164 FOCUSSED ON IS ESTABLISHING A 1507 00:59:00,164 --> 00:59:02,232 CHANGE IN THE UTERINE RESPONSE 1508 00:59:02,232 --> 00:59:03,734 TO A STIMULUS. 1509 00:59:03,734 --> 00:59:06,604 I SAY THAT SPECIFICALLY BECAUSE 1510 00:59:06,604 --> 00:59:09,673 IT'S A TERM I'LL REFERENCE. 1511 00:59:09,673 --> 00:59:11,609 UTERINE RESPONSE AND AT A HIGH 1512 00:59:11,609 --> 00:59:13,877 LEVEL WE KNOW THE UTERINE LINING 1513 00:59:13,877 --> 00:59:17,414 IS A SENSITIVE ORGAN AND KNOWS 1514 00:59:17,414 --> 00:59:21,018 WHEN TO SHED AND GROW AND WHEN 1515 00:59:21,018 --> 00:59:24,054 TO BECOME PLACENTA AND A 1516 00:59:24,054 --> 00:59:24,488 COORDINATED CASCADE. 1517 00:59:24,488 --> 00:59:26,590 WHEN THERE'S A SHIFT IN THAT 1518 00:59:26,590 --> 00:59:28,626 HORMONAL CASCADE WHETHER DUE TO 1519 00:59:28,626 --> 00:59:30,828 A PATHOGENIC CONDITION OR 1520 00:59:30,828 --> 00:59:32,396 NATURAL AGING IT WILL SHOW UP IN 1521 00:59:32,396 --> 00:59:33,964 THE UTERINE LINING. 1522 00:59:33,964 --> 00:59:38,369 THE CHALLENGE AND WORK NEEDED IS 1523 00:59:38,369 --> 00:59:40,504 TO ESTABLISH WHAT THE TYPICAL 1524 00:59:40,504 --> 00:59:42,206 BASELINE LOOKS LIKE AND NEED 1525 00:59:42,206 --> 00:59:43,107 MOLECULAR SIGNATURES OF 1526 00:59:43,107 --> 00:59:45,409 DIFFERENT DISEASES THAT SHOW UP 1527 00:59:45,409 --> 00:59:46,543 IN THE ENDOMETRIUM. 1528 00:59:46,543 --> 00:59:48,512 THIS IS WHERE MENSTRUAL BLOOD 1529 00:59:48,512 --> 00:59:49,113 COMES INTO PLAY. 1530 00:59:49,113 --> 00:59:51,682 EVERY MONTH YOUR BODY GIVES US 1531 00:59:51,682 --> 00:59:54,918 EASY ACCESS TO THIS IMPORTANT 1532 00:59:54,918 --> 00:59:57,087 TISSUE TYPE UTERINE LINING IN 1533 00:59:57,087 --> 00:59:57,888 THE FORM OF NATURAL BIOPSY. 1534 00:59:57,888 --> 01:00:00,257 THIS IS YOUR PERIOD. 1535 01:00:00,257 --> 01:00:02,826 WE CREATE A PLATFORM TO 1536 01:00:02,826 --> 01:00:04,728 ESTABLISH MOLECULAR PROFILES OF 1537 01:00:04,728 --> 01:00:06,430 SHED ENDOMETRIUM AT SCALE. 1538 01:00:06,430 --> 01:00:11,535 HOW DO WE DO IT? 1539 01:00:11,535 --> 01:00:16,240 A SAMPLIZED SET TO PROCESS THE 1540 01:00:16,240 --> 01:00:21,412 SAMPLE TIME AND THEN BIO 1541 01:00:21,412 --> 01:00:26,917 INFORMATIC TIME LINE. 1542 01:00:26,917 --> 01:00:30,387 A BENEFIT OF THE WINDOW INTO THE 1543 01:00:30,387 --> 01:00:32,990 UNIQUE SIGNATURE CRITICAL TO 1544 01:00:32,990 --> 01:00:34,024 UNDERSTANDING FEMALE BORN BODIES 1545 01:00:34,024 --> 01:00:37,428 AND ENABLES ACCESSING DIAGNOSIS 1546 01:00:37,428 --> 01:00:40,397 AND CAN LIVE IN A RURAL AREA IF 1547 01:00:40,397 --> 01:00:46,637 YOU CAN'T TAKE TIME OFF WORK FOR 1548 01:00:46,637 --> 01:00:51,008 IN-CLINIC PROCEDURE OR A 1549 01:00:51,008 --> 01:00:54,545 TEENAGER AND NOT READY FOR 1550 01:00:54,545 --> 01:00:57,181 SURGERY AND HOPE TO EXPAND 1551 01:00:57,181 --> 01:00:59,116 ACCESS BROADLY AND IT'S AN 1552 01:00:59,116 --> 01:01:01,685 INTERESTING WAY TO UNDERSTAND 1553 01:01:01,685 --> 01:01:04,088 THE DISEASE. 1554 01:01:04,088 --> 01:01:06,757 THIS IS A VISUAL REPRESENTATION 1555 01:01:06,757 --> 01:01:08,392 OF PATTERNS WE'RE EXPLORING AND 1556 01:01:08,392 --> 01:01:10,627 GOOD EXAMPLE OF WHAT WE CALL 1557 01:01:10,627 --> 01:01:11,829 UTERINE RESPONSE. 1558 01:01:11,829 --> 01:01:16,600 WE SEQUENCED TAMPONS FROM PEOPLE 1559 01:01:16,600 --> 01:01:19,737 WHO HAVE NO KNOWN PATHOLOGY AND 1560 01:01:19,737 --> 01:01:21,371 THEN SEEK TAMPONS WITH 1561 01:01:21,371 --> 01:01:22,539 INDIVIDUALS FROM ENDOMETRIOSIS 1562 01:01:22,539 --> 01:01:23,841 SO DETERMINE HOW THE SIGNATURE 1563 01:01:23,841 --> 01:01:26,009 SHIFTS AND WHETHER IT SHIFTS IN 1564 01:01:26,009 --> 01:01:31,715 A PREDICTABLE OR REPRODUCIBLE 1565 01:01:31,715 --> 01:01:35,285 MANNER. 1566 01:01:35,285 --> 01:01:37,488 YOU MIGHT WONDER IF THIS CHANGES 1567 01:01:37,488 --> 01:01:40,290 BASED ON AGE OR ETHNICITY OR 1568 01:01:40,290 --> 01:01:43,260 BIRTH CONTROL OR CONFOUNDED BY 1569 01:01:43,260 --> 01:01:44,428 OTHER ACUTE CONDITIONS YOU MAY 1570 01:01:44,428 --> 01:01:45,195 BE EXPERIENCE. 1571 01:01:45,195 --> 01:01:47,831 THESE ARE ALL GREAT QUESTIONS. 1572 01:01:47,831 --> 01:01:50,267 WE ARE BEGINNING TO UNDERSTAND 1573 01:01:50,267 --> 01:01:51,401 CERTAIN TYPE OF BIRTH CONTROL 1574 01:01:51,401 --> 01:01:53,303 FOR EXAMPLE DO MAKE A DIFFERENCE 1575 01:01:53,303 --> 01:01:55,005 IN THE MENSTRUAL SIGNATURE. 1576 01:01:55,005 --> 01:01:57,841 WE HAVE A CHANGE IN THE 1577 01:01:57,841 --> 01:01:59,009 SIGNATURE ACROSS AGE COHORTS. 1578 01:01:59,009 --> 01:02:02,079 WE'LL CONTINUE TO UNPACK AND 1579 01:02:02,079 --> 01:02:03,781 INVESTIGATE THE IMPACT OF THE 1580 01:02:03,781 --> 01:02:04,047 VARIABLES. 1581 01:02:04,047 --> 01:02:07,851 OUR GOAL IS TO CREATE A LARGE 1582 01:02:07,851 --> 01:02:12,956 ENOUGH OF UTTERINE PROFILES TO 1583 01:02:12,956 --> 01:02:17,060 UNDERSTAND A SET OF FEATURES. 1584 01:02:17,060 --> 01:02:23,233 A MORE NEAR TERM GOAL IS A 1585 01:02:23,233 --> 01:02:25,068 PREDICTIVELY ALTERED RESPONSE TO 1586 01:02:25,068 --> 01:02:25,402 ENDOMETRIOSIS. 1587 01:02:25,402 --> 01:02:29,673 WE ARE NOT LOOKING FOR ECTOPIC 1588 01:02:29,673 --> 01:02:31,842 TISSUE THAT MADE ITS WAY OUT BUT 1589 01:02:31,842 --> 01:02:33,677 LOOKING FOR WHAT IS SPECIFIC TO 1590 01:02:33,677 --> 01:02:37,414 THE ESTROGEN DOMINANCE THAT ARE 1591 01:02:37,414 --> 01:02:38,682 HALLMARK FEATURES OF 1592 01:02:38,682 --> 01:02:39,016 ENDOMETRIOSIS. 1593 01:02:39,016 --> 01:02:41,018 WE COLLECTED THOUSANDS OF 1594 01:02:41,018 --> 01:02:42,853 TAMPONS FROM HUNDREDS OF WOMEN 1595 01:02:42,853 --> 01:02:45,122 TO ESTABLISH, TEST AND VALIDATE 1596 01:02:45,122 --> 01:02:47,591 OUR ANALYSIS THAT A TAMPON WITH 1597 01:02:47,591 --> 01:02:48,392 SOMEONE FROM ENDOMETRIOSIS WILL 1598 01:02:48,392 --> 01:02:53,430 LOOK DIFFERENT ON A MOLECULAR 1599 01:02:53,430 --> 01:02:54,731 LEVEL TO SOMEONE WITHOUT 1600 01:02:54,731 --> 01:02:55,065 ENDOMETRIOSIS. 1601 01:02:55,065 --> 01:02:57,434 WE'RE CURRENTLY WORKING TO 1602 01:02:57,434 --> 01:02:59,570 ESTABLISH HOW WELL OUR TEST 1603 01:02:59,570 --> 01:03:03,140 WORKS IN PATIENTS WITH 1604 01:03:03,140 --> 01:03:05,442 INFERTILITY OR CHRONIC PELVIC 1605 01:03:05,442 --> 01:03:08,078 PAIN FUNDED IN PART BY NIH. 1606 01:03:08,078 --> 01:03:12,182 WE'RE ABLE TO PICK UP THE 1607 01:03:12,182 --> 01:03:14,184 DIFFERENCES BETWEEN THE SUBTYPES 1608 01:03:14,184 --> 01:03:15,819 OF SUPERFICIAL LESIONS. 1609 01:03:15,819 --> 01:03:18,555 WHAT WE'RE GOING AFTER WE 1610 01:03:18,555 --> 01:03:20,490 UNDERSTAND ENDOMETRIOSIS IS 1611 01:03:20,490 --> 01:03:22,226 EXTREMELY COMPLEX AND 1612 01:03:22,226 --> 01:03:22,759 HETEROGENEOUS. 1613 01:03:22,759 --> 01:03:25,596 WE'RE ANCHORED ON CAPTURING AND 1614 01:03:25,596 --> 01:03:27,664 BEING ABLE TO CHARACTERIZE A 1615 01:03:27,664 --> 01:03:30,567 UNIQUE SIGNATURE TO MULTIPLE 1616 01:03:30,567 --> 01:03:31,201 ESTROGEN-DOMINATED INFLAMMATORY 1617 01:03:31,201 --> 01:03:36,440 CONDITIONS. 1618 01:03:36,440 --> 01:03:38,308 I WALKED YOU THROUGH A SINGLE 1619 01:03:38,308 --> 01:03:41,945 EXAMPLE OF A NON-INVASIVE 1620 01:03:41,945 --> 01:03:45,115 DIAGNOSTIC WE THINK COULD BE 1621 01:03:45,115 --> 01:03:46,717 BENEFICIAL IN DIAGNOSTIC 1622 01:03:46,717 --> 01:03:49,519 ODYSSEYS WHETHER IT'S 1623 01:03:49,519 --> 01:03:52,289 FIBROMEIOSIS OR PCOS AND OTHERS 1624 01:03:52,289 --> 01:03:54,324 ARE NOT TREATED IN A TIMELY 1625 01:03:54,324 --> 01:03:55,993 MANNER BECAUSE DIAGNOSIS IS NOT 1626 01:03:55,993 --> 01:03:57,427 EASY. 1627 01:03:57,427 --> 01:03:58,896 THERE'S OTHER WAYS IN WHICH THE 1628 01:03:58,896 --> 01:04:00,764 DATA IN THE PLATFORM CAN CHANGE 1629 01:04:00,764 --> 01:04:02,466 HOW WE ACCESS CARE. 1630 01:04:02,466 --> 01:04:04,201 AN EASY TO USE DIAGNOSTIC CAN 1631 01:04:04,201 --> 01:04:05,969 ALSO BE LEVERAGED TO DETERMINE 1632 01:04:05,969 --> 01:04:12,342 WHETHER THERAPY IS EFFECTIVE. 1633 01:04:12,342 --> 01:04:13,410 YOU CAN IMAGINE WHETHER YOU'RE 1634 01:04:13,410 --> 01:04:17,281 HAVING SURGERY OR GOING ON 1635 01:04:17,281 --> 01:04:20,684 PROGESTERONE OR ANALOG AND COME 1636 01:04:20,684 --> 01:04:22,619 OFF IT ON HOLIDAY IT WOULD BE 1637 01:04:22,619 --> 01:04:23,687 HELPFUL TO UNDERSTAND WHETHER 1638 01:04:23,687 --> 01:04:26,857 THERE'S BEEN A MOLECULAR CHANGE 1639 01:04:26,857 --> 01:04:30,560 THAT IS INDICATIVE OF THE 1640 01:04:30,560 --> 01:04:31,595 THERAPY BEING EFFECTIVE. 1641 01:04:31,595 --> 01:04:33,697 WE HOPE THIS COULD BE BUILT IN 1642 01:04:33,697 --> 01:04:35,499 ONCE YOU HAVE EFFECTIVE 1643 01:04:35,499 --> 01:04:37,601 DIAGNOSIS SIMPLE ENOUGH TO 1644 01:04:37,601 --> 01:04:37,901 ADMINISTER. 1645 01:04:37,901 --> 01:04:39,369 THIS SLIDE IS SHOWING YOU SOME 1646 01:04:39,369 --> 01:04:40,037 REAL DATA. 1647 01:04:40,037 --> 01:04:41,872 WE'RE LOOKING AT 1648 01:04:41,872 --> 01:04:42,940 EXPRESSION-EXCHANGES OF TWO 1649 01:04:42,940 --> 01:04:43,674 GENES OF INTEREST. 1650 01:04:43,674 --> 01:04:46,009 I'M JUST GOING TO WALK YOU 1651 01:04:46,009 --> 01:04:47,210 THROUGH THE LEFT-HAND SIDE IN 1652 01:04:47,210 --> 01:04:48,979 HOW TO READ THE GRAPH. 1653 01:04:48,979 --> 01:04:50,647 THE FIRST BAR IN BRIGHT GREEN IS 1654 01:04:50,647 --> 01:04:54,584 EXPRESSION LEVELS OF THE GENE IN 1655 01:04:54,584 --> 01:04:56,954 A COMPLETELY HEALTHY COHORT AND 1656 01:04:56,954 --> 01:04:59,089 THE NEXT BAR IS PRE-SURGERY 1657 01:04:59,089 --> 01:05:00,657 TAMPONS FROM PEOPLE WE KNOW HAVE 1658 01:05:00,657 --> 01:05:00,991 ENDOMETRIOSIS. 1659 01:05:00,991 --> 01:05:03,860 THE THIRD BAR WHICH IS THE 1660 01:05:03,860 --> 01:05:06,563 LIGHTER GREEN IS POST-SURGERY 1661 01:05:06,563 --> 01:05:08,165 TAMPONS FROM PATIENTS WHERE AS 1662 01:05:08,165 --> 01:05:10,133 FAR AS WE KNOW THE SURGERY WAS 1663 01:05:10,133 --> 01:05:10,667 SUCCESSFUL. 1664 01:05:10,667 --> 01:05:13,403 AND FINALLY THE PALE YELLOW BAR 1665 01:05:13,403 --> 01:05:14,604 THE LAST BAR IS EXPRESSION 1666 01:05:14,604 --> 01:05:18,108 LEVELS FROM PATRONS WITH A 1667 01:05:18,108 --> 01:05:20,177 SURGERY THAT COULD NOT REMOVE 1668 01:05:20,177 --> 01:05:21,345 ALL THE ECTOPIC TISSUE. 1669 01:05:21,345 --> 01:05:25,482 YOU CAN SEE WE CAN TRACK HOW THE 1670 01:05:25,482 --> 01:05:29,152 EXPRESSION LEVELS OF KEY TARGETS 1671 01:05:29,152 --> 01:05:34,424 ARE CHANGING BASED ON WHETHER OR 1672 01:05:34,424 --> 01:05:36,626 NOT YOU HAVE ENDOMETRIOSIS AND 1673 01:05:36,626 --> 01:05:38,996 THIS IS WHAT CAN BE HELPFUL IN 1674 01:05:38,996 --> 01:05:42,332 TRACKING YOUR BODY'S RESPONSE ON 1675 01:05:42,332 --> 01:05:52,709 A MORE GRANULAR LEVEL. 1676 01:05:59,016 --> 01:06:01,118 AND SIX MONTHS POST SURGERY AND 1677 01:06:01,118 --> 01:06:03,153 12 MONTHS POST SURGERY AND WE 1678 01:06:03,153 --> 01:06:04,254 HAVE STEADY PARTICIPANTS WHO 1679 01:06:04,254 --> 01:06:08,392 HAVE BEEN IN OUR STUDY FOR YEARS 1680 01:06:08,392 --> 01:06:16,333 AND HAD A RECURRENCE AND 1681 01:06:16,333 --> 01:06:17,567 PROVIDED SAMPLING TO PROVIDE 1682 01:06:17,567 --> 01:06:19,936 INSIGHT TO THE PROGRESS OF THE 1683 01:06:19,936 --> 01:06:20,303 DISEASE. 1684 01:06:20,303 --> 01:06:23,273 THE LONGITUDINAL SAMPLING IS 1685 01:06:23,273 --> 01:06:25,742 ONLY POSSIBLE IF THE MEANS OF 1686 01:06:25,742 --> 01:06:28,245 COLLECTION IS SIMPLE ENOUGH. 1687 01:06:28,245 --> 01:06:38,789 I KEEP HAMMERING IN ON MENSTRUAL 1688 01:06:39,156 --> 01:06:41,425 AFFLUENCE BECAUSE IT'S EASY TO 1689 01:06:41,425 --> 01:06:43,126 COLLECT. 1690 01:06:43,126 --> 01:06:46,029 AND TEST NOVEL DRUG CANDIDATES 1691 01:06:46,029 --> 01:06:49,332 IN MODELS WITH EXPLORED HOW 1692 01:06:49,332 --> 01:06:50,667 CONCENTRATIONS FROM NOVEL DRUGS 1693 01:06:50,667 --> 01:06:52,536 IMPACT UTERINE PROFILES OVER 1694 01:06:52,536 --> 01:06:52,803 TIME. 1695 01:06:52,803 --> 01:06:54,571 WE'RE EXCITED BY THIS WORK 1696 01:06:54,571 --> 01:06:57,240 BECAUSE PRE-CLINICAL MODELS 1697 01:06:57,240 --> 01:07:00,877 BASED ON PATIENT-DERIVED CELLS 1698 01:07:00,877 --> 01:07:02,979 ARE AS CLOSE TO ANY HUMAN BEFORE 1699 01:07:02,979 --> 01:07:04,014 GETTING RESULTS. 1700 01:07:04,014 --> 01:07:05,682 THIS COULD IMPACT COST AND TIME 1701 01:07:05,682 --> 01:07:08,185 TO MARKET FOR NEW DRUG FOR 1702 01:07:08,185 --> 01:07:12,622 ENDOMETRIOSIS SUBSTANTIALLY. 1703 01:07:12,622 --> 01:07:15,659 AS MENTIONED ALL THIS RESEARCH 1704 01:07:15,659 --> 01:07:17,427 IS REALLY PATIENT DRIVEN AND 1705 01:07:17,427 --> 01:07:19,696 MOTIVATED BY THE PEOPLE WANTING 1706 01:07:19,696 --> 01:07:22,432 TO UNDERSTAND AND DERIVE WHAT IS 1707 01:07:22,432 --> 01:07:25,335 MENSTRUATION AND THE GENOMICS OF 1708 01:07:25,335 --> 01:07:30,640 THE UTERINE PROFILES AND USE IT 1709 01:07:30,640 --> 01:07:32,609 AS A DIAGNOSTIC LEVER. 1710 01:07:32,609 --> 01:07:37,414 WE COLLECTED 2,000 SAMPLES OF 1711 01:07:37,414 --> 01:07:41,017 CANDIDATES SOME WE SEQUENTIALLY 1712 01:07:41,017 --> 01:07:43,553 FOLLOWED FOR A YEAR OR YEAR 1713 01:07:43,553 --> 01:07:43,787 PLUS. 1714 01:07:43,787 --> 01:07:46,857 I CAN'T RESIST ENDING THE TALK 1715 01:07:46,857 --> 01:07:49,092 WITHOUT MY FINAL SLIDE WHICH IS 1716 01:07:49,092 --> 01:07:52,429 IF YOU ARE INTERESTED, YOU CAN 1717 01:07:52,429 --> 01:07:53,430 ABSOLUTELY SCAN THE QR CODE AND 1718 01:07:53,430 --> 01:07:55,265 LEARN MORE ABOUT THE RESEARCH 1719 01:07:55,265 --> 01:07:57,033 WE'RE DOING AND SHARE IT. 1720 01:07:57,033 --> 01:08:00,570 AS I MENTIONED THE TOTAL VISION 1721 01:08:00,570 --> 01:08:01,138 OF UNDERSTANDING HOW 1722 01:08:01,138 --> 01:08:02,772 ENDOMETRIOSIS IS DIFFER BASED 1723 01:08:02,772 --> 01:08:07,811 WHETHER YOU HAVE OTHER 1724 01:08:07,811 --> 01:08:11,014 COMORBIDITIES OR AUTOIMMUNE 1725 01:08:11,014 --> 01:08:13,416 CONDITIONS TO PARS THROUGH THAT. 1726 01:08:13,416 --> 01:08:15,085 WE'LL HAVE A CALL TO ACTION TO 1727 01:08:15,085 --> 01:08:17,354 SAY IF YOU CAN PARTICIPATE OR 1728 01:08:17,354 --> 01:08:18,622 KNOW SOMEONE WHO CAN IS A 1729 01:08:18,622 --> 01:08:20,056 FUNDAMENTAL AND PROFOUND WAY TO 1730 01:08:20,056 --> 01:08:21,424 MOVE THE RESEARCH FORWARD. 1731 01:08:21,424 --> 01:08:31,601 THANK YOU. 1732 01:08:34,337 --> 01:08:35,805 >> THANK YOU FOR ENDING ON THAT 1733 01:08:35,805 --> 01:08:41,011 SLIDE BECAUSE THERE'S TONS OF 1734 01:08:41,011 --> 01:08:44,314 QUESTIONS AND IT'S NICE WOMEN 1735 01:08:44,314 --> 01:08:46,283 CAN COLLECT SAMPLE IN THEIR OWN 1736 01:08:46,283 --> 01:08:50,754 HOME AND MAKE IT WOMAN-CENTRIC 1737 01:08:50,754 --> 01:08:53,156 OR PATIENT-CENTRIC WAY OF 1738 01:08:53,156 --> 01:08:53,456 COLLECTION. 1739 01:08:53,456 --> 01:08:54,791 THANK YOU FOR THAT. 1740 01:08:54,791 --> 01:08:55,659 THERE'S LOTS OF QUESTIONS IN THE 1741 01:08:55,659 --> 01:08:57,194 CHAT IF YOU WANT TO TRY TO 1742 01:08:57,194 --> 01:08:58,962 ANSWER SOME OF THOSE. 1743 01:08:58,962 --> 01:09:01,097 CERTAINLY SOME OF YOUR POTENTIAL 1744 01:09:01,097 --> 01:09:02,399 FUTURE COLLABORATORS WOULD LIKE 1745 01:09:02,399 --> 01:09:03,867 TO KNOW ABOUT COLLABORATING WITH 1746 01:09:03,867 --> 01:09:05,001 YOUR DATA SET AS WELL. 1747 01:09:05,001 --> 01:09:06,803 I'LL LET YOU ANSWER THOSE. 1748 01:09:06,803 --> 01:09:08,371 I KNOW YOU COLLABORATE VERY WELL 1749 01:09:08,371 --> 01:09:10,907 BECAUSE I KNOW MANY PARTNERSHIPS 1750 01:09:10,907 --> 01:09:11,975 YOU'RE PART OF. 1751 01:09:11,975 --> 01:09:13,743 I'LL LET YOU ANSWER THOSE 1752 01:09:13,743 --> 01:09:15,512 QUESTIONS AND ASK THE REST OF 1753 01:09:15,512 --> 01:09:17,681 OUR PANEL, THANK YOU, RIDHI, BUT 1754 01:09:17,681 --> 01:09:23,119 I'LL ASK EVERYONE TO JOIN YOU ON 1755 01:09:23,119 --> 01:09:28,091 CAMERA SO WE CAN START ASKING 1756 01:09:28,091 --> 01:09:32,762 AND I APOLOGIZE TO THE AUDIENCE 1757 01:09:32,762 --> 01:09:34,998 NOW BUT I WE WON'T GET THROUGH 1758 01:09:34,998 --> 01:09:38,134 ALL 45 OR SO QUESTIONS TODAY BUT 1759 01:09:38,134 --> 01:09:40,337 TRY TO GO THROUGH AS MANY AS WE 1760 01:09:40,337 --> 01:09:42,572 CAN AND TRY TO HAVE FOLLOW-UP 1761 01:09:42,572 --> 01:09:44,741 FROM OUR PANELISTS LATER ON AND 1762 01:09:44,741 --> 01:09:46,042 TRY TO SUM UP SOME QUESTIONS. 1763 01:09:46,042 --> 01:09:47,944 I WANT TO START WITH A QUESTION 1764 01:09:47,944 --> 01:09:49,813 FOR ALL OF YOU, MAYBE STARTING 1765 01:09:49,813 --> 01:09:56,152 WITH YOU, DIANA, WE TALKED ABOUT 1766 01:09:56,152 --> 01:09:57,954 BEING YOUR OWN BEST ADVOCATE AND 1767 01:09:57,954 --> 01:09:59,322 KNOWLEDGE IS POWER THAT'S 1768 01:09:59,322 --> 01:10:01,424 SOMETHING YOU SAID AND MULTIPLE 1769 01:10:01,424 --> 01:10:02,192 PEOPLE SAID. 1770 01:10:02,192 --> 01:10:04,728 HOW DO WE OPERATIONALIZE THAT 1771 01:10:04,728 --> 01:10:08,431 AND WHAT'S THEIR FIRST STEP 1772 01:10:08,431 --> 01:10:09,766 MAKING SURE THEY'RE THEIR OWN 1773 01:10:09,766 --> 01:10:10,900 BEST ADVOCATE HERE? 1774 01:10:10,900 --> 01:10:14,237 >> I HAVE A LOVE-HATE OR 1775 01:10:14,237 --> 01:10:15,805 LOVE-LOATHE WITH THAT EXPRESSION 1776 01:10:15,805 --> 01:10:16,973 TO BE YOUR BEST ADVOCATE BECAUSE 1777 01:10:16,973 --> 01:10:18,908 ONCE AGAIN WE'RE PUTTING THE 1778 01:10:18,908 --> 01:10:20,944 BURDEN ON THE PATIENT TO HAVE 1779 01:10:20,944 --> 01:10:23,146 THE ONUS AND RESPONSIBILITY IN 1780 01:10:23,146 --> 01:10:24,080 THE MEDICAL KNOWLEDGE WHEN THEY 1781 01:10:24,080 --> 01:10:30,453 ALREADY ARE AT A HEIGHTENED 1782 01:10:30,453 --> 01:10:32,689 STATE OF PAIN AND CONFUSION AND 1783 01:10:32,689 --> 01:10:34,524 HARD PLACE TO BE IN SO I WANT TO 1784 01:10:34,524 --> 01:10:36,893 GIVE THAT EMPATHY RIGHT THERE. 1785 01:10:36,893 --> 01:10:38,962 WHEN YOU GET TO A DOCTOR'S 1786 01:10:38,962 --> 01:10:40,563 OFFICE, TRY TO COME AS PREPARED 1787 01:10:40,563 --> 01:10:44,067 AS POSSIBLE. 1788 01:10:44,067 --> 01:10:45,769 IF YOU'RE NOT SOMEONE WHO CAN 1789 01:10:45,769 --> 01:10:47,737 EASILY ADVOCATE FOR YOURSELF OR 1790 01:10:47,737 --> 01:10:49,572 GET INTIMIDATED BY BEING IN A 1791 01:10:49,572 --> 01:10:52,242 DOCTOR'S OFFICE, GO THERE WITH 1792 01:10:52,242 --> 01:10:53,109 SOME QUESTIONS PREPARED. 1793 01:10:53,109 --> 01:10:53,877 GO WITH A TRACK OF YOUR 1794 01:10:53,877 --> 01:11:02,285 SYMPTOMS. 1795 01:11:02,285 --> 01:11:04,988 MAKE SURE THE DOCTOR HEARS YOU 1796 01:11:04,988 --> 01:11:05,655 AND LISTENS TO YOU. 1797 01:11:05,655 --> 01:11:11,261 SAY THESE ARE MY TOP THREE 1798 01:11:11,261 --> 01:11:11,895 CONCERNS. 1799 01:11:11,895 --> 01:11:13,763 THESE ARE MY TOP SYMPTOMS. 1800 01:11:13,763 --> 01:11:15,932 THIS IS WHAT I'M NOTICING. 1801 01:11:15,932 --> 01:11:18,768 AS GREAT AS DOCTORS I'VE COME 1802 01:11:18,768 --> 01:11:20,103 ACROSS I'VE HAD TO DO THE HOME 1803 01:11:20,103 --> 01:11:22,939 WORK FOR THEM BECAUSE THEY DON'T 1804 01:11:22,939 --> 01:11:28,244 KNOW ME OR MY PAST. 1805 01:11:28,244 --> 01:11:33,483 I GO THROUGH LOADED WITH MY OWN 1806 01:11:33,483 --> 01:11:34,951 KNOWLEDGE AND HISTORY. 1807 01:11:34,951 --> 01:11:40,757 AND WHEN I KNOW I'M GETTING LOST 1808 01:11:40,757 --> 01:11:42,625 IN THEIR HISTORY I TRY TO 1809 01:11:42,625 --> 01:11:43,159 REFOCUS. 1810 01:11:43,159 --> 01:11:45,662 GO ARMED WITH YOUR OWN PERSONAL 1811 01:11:45,662 --> 01:11:46,796 MEDICAL HISTORY AND SAYING THIS 1812 01:11:46,796 --> 01:11:47,764 IS NOT NORMAL FOR ME. 1813 01:11:47,764 --> 01:11:49,632 I KNOW MY BODY. 1814 01:11:49,632 --> 01:11:51,101 ULTIMATELY YOU'VE LIVED IN YOUR 1815 01:11:51,101 --> 01:11:53,503 BODY, YOU KNOW YOUR BODY BEST. 1816 01:11:53,503 --> 01:11:57,340 IT SOUNDS SIMPLIFIED BUT IT'S A 1817 01:11:57,340 --> 01:11:59,242 GOOD STARTING POINT. 1818 01:11:59,242 --> 01:12:03,313 >> SUSIE, FROM A CLINICIAN'S 1819 01:12:03,313 --> 01:12:05,882 POINT OF CARE, CLINICIANS PEOPLE 1820 01:12:05,882 --> 01:12:07,550 ENCOUNTER FIRST WON'T BE 1821 01:12:07,550 --> 01:12:09,219 GYNECOLOGISTS OR SPECIALISTS IN 1822 01:12:09,219 --> 01:12:09,619 ENDOMETRIOSIS. 1823 01:12:09,619 --> 01:12:10,920 OBVIOUSLY WE'RE ALL WORKING 1824 01:12:10,920 --> 01:12:13,423 TOGETHER TO MAKE THE MEDICAL 1825 01:12:13,423 --> 01:12:14,624 SCHOOL EDUCATION BETTER ACROSS 1826 01:12:14,624 --> 01:12:15,658 THE SPECIALTIES BUT DO YOU HAVE 1827 01:12:15,658 --> 01:12:17,394 ADVICE FOR PEOPLE IN THE 1828 01:12:17,394 --> 01:12:18,762 AUDIENCE WHO MAY BE SEEING A 1829 01:12:18,762 --> 01:12:20,330 CLINICIAN FOR THE FIRST TIME OR 1830 01:12:20,330 --> 01:12:23,466 BRINGING THIS UP AFTER A TALK 1831 01:12:23,466 --> 01:12:25,735 AND SAYING I THINK IT IS ENDO 1832 01:12:25,735 --> 01:12:27,404 AND WHAT THEY CAN DO TO GET THE 1833 01:12:27,404 --> 01:12:28,438 MESSAGE ACROSS? 1834 01:12:28,438 --> 01:12:35,044 >> IT'S A GREAT QUESTION. 1835 01:12:35,044 --> 01:12:37,113 PATIENTS SHOULD BE ABLE TO 1836 01:12:37,113 --> 01:12:38,648 ADVOCATE FOR THEMSELVES AND IT'S 1837 01:12:38,648 --> 01:12:41,418 ALSO OUR DUTY AS CLINICIANS TO 1838 01:12:41,418 --> 01:12:44,954 LISTEN TO PATIENTS AND TO 1839 01:12:44,954 --> 01:12:52,228 RECOGNIZE THAT WHEN SOMETHING 1840 01:12:52,228 --> 01:12:53,196 DOESN'T FEEL RIGHT IT'S WITHIN 1841 01:12:53,196 --> 01:12:54,364 THEIR SCOPE AND TRAINING TO TAKE 1842 01:12:54,364 --> 01:12:56,366 CARE OF THAT AND IF NOT THEY 1843 01:12:56,366 --> 01:12:57,667 HELP THEM FIND THE RIGHT DOCTOR 1844 01:12:57,667 --> 01:12:58,668 TO DO THAT. 1845 01:12:58,668 --> 01:13:02,672 THE VAST MAJORITY OF PATIENTS AS 1846 01:13:02,672 --> 01:13:04,874 DIANA SAID WITH ENDOMETRIOSIS 1847 01:13:04,874 --> 01:13:07,811 PRESENT WITH SYMPTOMS SINCE 1848 01:13:07,811 --> 01:13:09,679 ADOLESCENCE BUT DON'T GET 1849 01:13:09,679 --> 01:13:14,317 DIAGNOSED UNTIL THEIR OLDER. 1850 01:13:14,317 --> 01:13:19,289 BEING VERY PROACTIVE ABOUT 1851 01:13:19,289 --> 01:13:22,492 MANAGING THOSE SYSTEMS TO YOUR 1852 01:13:22,492 --> 01:13:23,827 NUTRITION AND PRIMARY 1853 01:13:23,827 --> 01:13:24,928 GYNECOLOGISTS AND BRINGING UP 1854 01:13:24,928 --> 01:13:28,198 THE POSSIBILITY DO YOU THINK 1855 01:13:28,198 --> 01:13:30,233 THIS IS ENDOMETRIOSIS AND 1856 01:13:30,233 --> 01:13:31,434 DEPENDING ON THE PHYSICIAN'S 1857 01:13:31,434 --> 01:13:32,635 RESPONSE YOU MAY BE ABLE TO 1858 01:13:32,635 --> 01:13:34,070 GAUGE IS THIS THE RIGHT DOCTOR 1859 01:13:34,070 --> 01:13:39,542 FOR YOU AND IF NOT, TRY TO ASK 1860 01:13:39,542 --> 01:13:42,212 THEM TO GET ADVICE WHO WOULD BE 1861 01:13:42,212 --> 01:13:43,513 THE EXPERTS IN THE COMMUNITY 1862 01:13:43,513 --> 01:13:44,547 THAT COULD HELP THEM. 1863 01:13:44,547 --> 01:13:46,583 THERE ARE A LOT OF RESOURCES 1864 01:13:46,583 --> 01:13:48,318 ONLINE THAT CAN HELP PATIENTS AS 1865 01:13:48,318 --> 01:13:50,620 WELL AND WE CAN DEFINITELY PUT 1866 01:13:50,620 --> 01:13:51,588 SOME OF THAT INFORMATION OUT 1867 01:13:51,588 --> 01:13:51,788 THERE. 1868 01:13:51,788 --> 01:13:57,026 >> THANK YOU. 1869 01:13:57,026 --> 01:13:58,461 >> STACEY, YOUR TALK BROUGHT UP 1870 01:13:58,461 --> 01:14:00,964 THE RISK FACTOR FOR OTHER 1871 01:14:00,964 --> 01:14:04,033 CONDITIONS THAT MAY OVERLAP WITH 1872 01:14:04,033 --> 01:14:04,367 ENDOMETRIOSIS. 1873 01:14:04,367 --> 01:14:07,303 IT SEEMS ENDOMETRIAL AND OVARIAN 1874 01:14:07,303 --> 01:14:08,204 CANCER ARE BEING QUESTIONED 1875 01:14:08,204 --> 01:14:09,639 WITHIN THE CHAT. 1876 01:14:09,639 --> 01:14:11,274 I KNOW YOU HAVE WORK ON THIS. 1877 01:14:11,274 --> 01:14:15,678 IF YOU CAN TALK ABOUT HOW 1878 01:14:15,678 --> 01:14:17,247 THEY'RE RELATED AND MAYBE HOW IN 1879 01:14:17,247 --> 01:14:21,284 TERMS OF SEQUENCE OF EVENTS 1880 01:14:21,284 --> 01:14:22,218 OVARIAN VERSUS ENDOMETRIOSIS AND 1881 01:14:22,218 --> 01:14:24,621 WHETHER THEY HAPPEN AT THE SAME 1882 01:14:24,621 --> 01:14:24,821 TIME. 1883 01:14:24,821 --> 01:14:27,490 >> ABSOLUTELY. 1884 01:14:27,490 --> 01:14:29,826 YOU JUST DESCRIBED WHAT MAKES 1885 01:14:29,826 --> 01:14:33,062 THIS DISCOVERY AND THE CLINICAL 1886 01:14:33,062 --> 01:14:34,330 CARE DIFFICULT. 1887 01:14:34,330 --> 01:14:39,502 WHICH IS THE SEQUENCE OF EVENTS. 1888 01:14:39,502 --> 01:14:41,638 FOR ENDOMETRIAL CANCER IT SHOWS 1889 01:14:41,638 --> 01:14:43,740 A GREATER RISK OF CANCER OF 1890 01:14:43,740 --> 01:14:45,975 THOSE WITH ENDOMETRIOSIS BUT 1891 01:14:45,975 --> 01:14:47,977 WHEN WE LOOK AT ENDOMETRIAL 1892 01:14:47,977 --> 01:14:49,279 CANCER DIAGNOSED AT THE SAME 1893 01:14:49,279 --> 01:14:51,548 TIME AS ENDOMETRIOSIS, THE 1894 01:14:51,548 --> 01:14:52,849 ENDOMETRIOSIS IS DISCOVERED 1895 01:14:52,849 --> 01:14:57,420 BECAUSE OF THE EVALUATION FOR 1896 01:14:57,420 --> 01:14:59,222 ENDOMETRIAL CANCER AND THINKING 1897 01:14:59,222 --> 01:15:02,959 OF CAUSE AND EFFECT AND THINKING 1898 01:15:02,959 --> 01:15:05,595 OF ENDOMETRIOSIS AS THE PEOPLE 1899 01:15:05,595 --> 01:15:07,630 WITH HIGHER RISK AND SUBSEQUENT 1900 01:15:07,630 --> 01:15:10,600 RISK WE SEE NO PRIOR ASSOCIATION 1901 01:15:10,600 --> 01:15:12,035 BETWEEN ENDOMETRIOSIS AND 1902 01:15:12,035 --> 01:15:12,869 ENDOMETRIAL CANCER. 1903 01:15:12,869 --> 01:15:14,604 OVARIAN CANCER IS A DIFFERENT 1904 01:15:14,604 --> 01:15:14,804 STORY. 1905 01:15:14,804 --> 01:15:17,574 WE ABSOLUTELY SEE A CONSISTENT 1906 01:15:17,574 --> 01:15:21,044 INCREASED RISK OF OVARIAN CANCER 1907 01:15:21,044 --> 01:15:26,316 WITH ENDOMETRIOSIS AND THE KEY 1908 01:15:26,316 --> 01:15:29,786 QUESTIONS FOR US NOW ARE THE 1909 01:15:29,786 --> 01:15:31,054 PEOPLE WITH ENDOMETRIOSIS HAVE 1910 01:15:31,054 --> 01:15:33,256 HIGHER RISK? 1911 01:15:33,256 --> 01:15:43,700 IS IT ONLY THOSE WITH EN 1912 01:15:48,237 --> 01:15:49,305 ENDOMITRIOMAS OR THOSE WITH 1913 01:15:49,305 --> 01:15:53,109 LESIONS AND HOW LARGE THE RISK 1914 01:15:53,109 --> 01:15:53,910 IS. 1915 01:15:53,910 --> 01:15:56,346 OVARIAN CANCER IS VERY RARE. 1916 01:15:56,346 --> 01:15:58,848 THERE'S A 1% CHANCE ACROSS A 1917 01:15:58,848 --> 01:16:02,385 WOMAN'S LIFE TIME OF DEVELOPING 1918 01:16:02,385 --> 01:16:04,120 OVARIAN CANCER AND BY CURRENT 1919 01:16:04,120 --> 01:16:06,556 DATA ABOUT A DOUBLE RISK. 1920 01:16:06,556 --> 01:16:09,392 SO 2% RISK WHICH IS MUCH SMALLER 1921 01:16:09,392 --> 01:16:11,194 THAN MANY MANY OTHER HEALTH 1922 01:16:11,194 --> 01:16:11,661 CONDITIONS. 1923 01:16:11,661 --> 01:16:17,066 FIGURING OUT WHO IS AT RISK AND 1924 01:16:17,066 --> 01:16:23,539 ALSO FIGURING OUT WHEN AGAIN THE 1925 01:16:23,539 --> 01:16:25,541 ENDOMETRIOSIS IS FOUND AND THE 1926 01:16:25,541 --> 01:16:26,876 PEOPLE WITH OVARIAN CANCER 1927 01:16:26,876 --> 01:16:28,645 DIDN'T HAVE THEIR CHANCE TO HAVE 1928 01:16:28,645 --> 01:16:30,313 THE ENDOMETRIOSIS DIAGNOSED. 1929 01:16:30,313 --> 01:16:35,251 THIS IS ANOTHER AREA WHERE A 1930 01:16:35,251 --> 01:16:39,689 NON-INVASIVE DIAGNOSTIC WHICH 1931 01:16:39,689 --> 01:16:45,294 WOULD GIVE A SENSE OF ASPECT OF 1932 01:16:45,294 --> 01:16:49,065 RISK OF HEART ATTACKS AND 1933 01:16:49,065 --> 01:16:50,400 SYMPTOMS AND DIAGNOSTICS AND ALL 1934 01:16:50,400 --> 01:16:53,403 THE ASPECTS OF CLINICAL CARE 1935 01:16:53,403 --> 01:16:56,105 ONCE WE CAN REMOVE THE BARRIERS 1936 01:16:56,105 --> 01:16:57,674 AROUND THAT WE'LL HAVE A MUCH 1937 01:16:57,674 --> 01:16:58,474 BETTER UNDERSTANDING. 1938 01:16:58,474 --> 01:17:03,179 BUT THAT IS THE KEY ISSUE OF NOT 1939 01:17:03,179 --> 01:17:06,816 FRIGHTENING WOMEN AND MAKING 1940 01:17:06,816 --> 01:17:08,985 IMPORTANT SENSIBLE DECISIONS 1941 01:17:08,985 --> 01:17:12,488 BASED ON THE DATA WE HAVE NOW. 1942 01:17:12,488 --> 01:17:13,756 >> THANK YOU. 1943 01:17:13,756 --> 01:17:15,692 I'LL OPEN THIS UP TO THE WHOLE 1944 01:17:15,692 --> 01:17:17,493 PANEL BECAUSE I DON'T KNOW WHO 1945 01:17:17,493 --> 01:17:19,595 HAS SOMETHING TO SAY BUT THERE'S 1946 01:17:19,595 --> 01:17:21,297 A LOT OF QUESTIONS ABOUT 1947 01:17:21,297 --> 01:17:22,932 ENVIRONMENTAL TOXIN AND THE 1948 01:17:22,932 --> 01:17:24,567 CHEMICALS WE COME IN CONTACT 1949 01:17:24,567 --> 01:17:26,836 WITH DAY AFTER DAY. 1950 01:17:26,836 --> 01:17:29,105 I DON'T KNOW IF YOU HAVE STUDIED 1951 01:17:29,105 --> 01:17:31,274 THIS OR TALK ABOUT WHAT WE KNOW 1952 01:17:31,274 --> 01:17:33,009 ABOUT RISK FACTORS. 1953 01:17:33,009 --> 01:17:35,812 OBVIOUSLY THERE'S ESTROGENS OR 1954 01:17:35,812 --> 01:17:37,246 HORMONAL INFLUENCING CHEMICALS. 1955 01:17:37,246 --> 01:17:39,148 THERE'S SOME RISK FACTORS THERE. 1956 01:17:39,148 --> 01:17:41,150 I WILL OPEN IT UP TO ANYONE WHO 1957 01:17:41,150 --> 01:17:44,120 WANTS TO TALK ABOUT THIS. 1958 01:17:44,120 --> 01:17:47,190 >> I THINK THIS IS A STACEY 1959 01:17:47,190 --> 01:17:48,958 QUESTION BUT I'LL ADD ONE THING 1960 01:17:48,958 --> 01:17:57,133 WE TRY TO DO IS WE KNOW WE ARE 1961 01:17:57,133 --> 01:17:57,767 GENERA 1962 01:17:57,767 --> 01:18:01,404 GENERA 1963 01:18:01,404 --> 01:18:07,043 GENERATING TERABYTES AND WE HAVE 1964 01:18:07,043 --> 01:18:08,778 INTENSE SURVEY INSTRUMENTS -- 1965 01:18:08,778 --> 01:18:10,179 >> I'VE TAKEN THAT SURVEY. 1966 01:18:10,179 --> 01:18:11,247 IT IS INTENSE. 1967 01:18:11,247 --> 01:18:13,416 >> THANK YOU. 1968 01:18:13,416 --> 01:18:15,651 YOU'RE A SOLDIER FOR DOING IT 1969 01:18:15,651 --> 01:18:21,390 YOU CAN DO IT AT SURVEY AT NEXT 1970 01:18:21,390 --> 01:18:25,995 GEN JANE DOT COM AND TRY TO 1971 01:18:25,995 --> 01:18:28,798 DEVELOP THE MAPS. 1972 01:18:28,798 --> 01:18:31,868 WE HAVEN'T DONE EXPERIMENTS YET 1973 01:18:31,868 --> 01:18:33,002 DIRECTLY LINKING EXPOSURE TO 1974 01:18:33,002 --> 01:18:34,637 WHAT WE'RE SEEING IN THE 1975 01:18:34,637 --> 01:18:35,938 MENSTRUAL SIGNAL WHICH WE'RE 1976 01:18:35,938 --> 01:18:38,608 INTERESTED IN DOING BUT LAYING 1977 01:18:38,608 --> 01:18:39,509 THE GROUND WORK AND START 1978 01:18:39,509 --> 01:18:41,177 COLLECTING THE FEATURES THAT 1979 01:18:41,177 --> 01:18:42,578 COULD BE HELPFUL AND 1980 01:18:42,578 --> 01:18:44,347 UNDERSTANDING THE DATA WE'RE 1981 01:18:44,347 --> 01:18:45,414 SEEING DOWN STREAM EVEN IF WE'RE 1982 01:18:45,414 --> 01:18:46,282 NOT DOING IT CURRENTLY. 1983 01:18:46,282 --> 01:18:49,051 >> THANK YOU. 1984 01:18:49,051 --> 01:18:53,489 >> AND STACEY, YOU CAN TALK MORE 1985 01:18:53,489 --> 01:18:58,327 ABOUT THE RISK FACTORS. 1986 01:18:58,327 --> 01:19:03,699 >> I'LL CALL OUT WITH RESPECT TO 1987 01:19:03,699 --> 01:19:07,003 THE IMPORTANT MAPS FIGURING OUT 1988 01:19:07,003 --> 01:19:08,137 WHEN PEOPLE WERE EXPOSED, THE 1989 01:19:08,137 --> 01:19:10,706 DOSAGE OF THAT EXPOSURE AND THE 1990 01:19:10,706 --> 01:19:13,376 TIMING IN THEIR LIVES IS QUITE 1991 01:19:13,376 --> 01:19:13,643 COMPLEX. 1992 01:19:13,643 --> 01:19:15,545 BUT AS TECHNOLOGY IS IMPROVING 1993 01:19:15,545 --> 01:19:20,817 AND WE HAVE THESE GEOCODING MAPS 1994 01:19:20,817 --> 01:19:22,785 AND MANY HAVE BEEN DOING WORK IN 1995 01:19:22,785 --> 01:19:24,720 THIS SPACE. 1996 01:19:24,720 --> 01:19:27,623 WHAT WE KNOW IS THAT WHEN WE 1997 01:19:27,623 --> 01:19:29,392 LOOK RIGHT NOW IN WOMEN IN THEIR 1998 01:19:29,392 --> 01:19:33,429 SAY 30s AND 40s AND LOOK AT 1999 01:19:33,429 --> 01:19:39,368 LEVELS OF PHYTO ESTROGENS AND 2000 01:19:39,368 --> 01:19:40,603 OWNER EXPOSURE WE DON'T SEE 2001 01:19:40,603 --> 01:19:43,005 CORRELATIONS BUT THAT'S LIKELY 2002 01:19:43,005 --> 01:19:44,774 BECAUSE THE IMPACTFUL WINDOW WAS 2003 01:19:44,774 --> 01:19:48,311 AT BIRTH, CHILDHOOD OR EARLY 2004 01:19:48,311 --> 01:19:50,580 ADOLESCENCE. 2005 01:19:50,580 --> 01:19:51,681 AGAIN, MAPPING THOSE AND HAVING 2006 01:19:51,681 --> 01:19:52,715 THOSE STUDIES IS CRITICAL AND 2007 01:19:52,715 --> 01:19:53,182 IMPORTANT. 2008 01:19:53,182 --> 01:19:54,650 >> THANK YOU. 2009 01:19:54,650 --> 01:19:56,886 THAT'S A PERFECT SEGUE TO THE 2010 01:19:56,886 --> 01:19:59,956 NEXT QUESTION WHICH HAS COME UP 2011 01:19:59,956 --> 01:20:03,693 MANY TIMES ABOUT THE EXPERIENCE 2012 01:20:03,693 --> 01:20:07,663 OF ENDOMETRIOSIS IN YOUNG GIRLS 2013 01:20:07,663 --> 01:20:14,337 AND, DIANA DOES IT START WITH 2014 01:20:14,337 --> 01:20:16,505 YOUR FIRST PERIOD. 2015 01:20:16,505 --> 01:20:19,408 HOW DID IT START IN YOUR 2016 01:20:19,408 --> 01:20:19,709 ADOLESCENCE? 2017 01:20:19,709 --> 01:20:23,846 >> I'M NOT A SCIENTIST OR DOCTOR 2018 01:20:23,846 --> 01:20:25,648 BUT FROM MY PATIENT PERSPECTIVE 2019 01:20:25,648 --> 01:20:27,683 I WOULD SAY IT WAS WITHIN THE 2020 01:20:27,683 --> 01:20:35,157 FIRST FEW CYCLES THAT I WAS 2021 01:20:35,157 --> 01:20:37,026 HAVING MENSTRUAL PAIN -- I'M 2022 01:20:37,026 --> 01:20:38,427 GOING TO GET GRAPHIC BUT VERY 2023 01:20:38,427 --> 01:20:41,664 HEAVY FLOW AND IT WOULD BE FOR 2024 01:20:41,664 --> 01:20:42,565 OVER SOMETIMES BETWEEN 10 TO 14 2025 01:20:42,565 --> 01:20:49,105 HAD DAYS OF A CYCLE WHICH WAS 2026 01:20:49,105 --> 01:20:50,006 NOT NORMAL. 2027 01:20:50,006 --> 01:20:51,207 THAT WOULD COME WITH OTHER 2028 01:20:51,207 --> 01:20:51,474 SYMPTOMS. 2029 01:20:51,474 --> 01:20:54,143 AS I GOT OLDER AND PROGRESSED TO 2030 01:20:54,143 --> 01:20:56,946 HIGH SCHOOL I STARTED DEVELOPING 2031 01:20:56,946 --> 01:21:00,383 OVARIAN CYSTS AND HAD MY FIRST 2032 01:21:00,383 --> 01:21:01,751 RUPTURE AROUND 14 YEARS OLD. 2033 01:21:01,751 --> 01:21:05,254 AT THAT POINT LIKE I SAID IT WAS 2034 01:21:05,254 --> 01:21:07,056 21 YEARS TO DIAGNOSIS. 2035 01:21:07,056 --> 01:21:12,662 I WAS PUT ON BIRTH CONTROL PILLS 2036 01:21:12,662 --> 01:21:15,564 AND SUPPRESSION ON AND OVER AND 2037 01:21:15,564 --> 01:21:17,667 NOT ONCE DID I HEAR IT WAS 2038 01:21:17,667 --> 01:21:18,834 ENDOMETRIOSIS OR A DISEASE. 2039 01:21:18,834 --> 01:21:20,903 BY THE TIME I WAS DIAGNOSED I 2040 01:21:20,903 --> 01:21:23,606 HAD ADVANCED DISEASE AND 2041 01:21:23,606 --> 01:21:25,007 INFERTILITY AT 32. 2042 01:21:25,007 --> 01:21:27,677 AND THE SYMPTOMS KEPT GETTING 2043 01:21:27,677 --> 01:21:31,714 MORE ACUTE AND OBVIOUSLY ALSO 2044 01:21:31,714 --> 01:21:32,248 EXTRA PELVIC. 2045 01:21:32,248 --> 01:21:34,317 >> SUSIE AND STACEY DO YOU WANT 2046 01:21:34,317 --> 01:21:35,952 TO TALK MORE ABOUT HOW COMMON IT 2047 01:21:35,952 --> 01:21:38,621 IS TO HAVE THESE SYMPTOMS OF 2048 01:21:38,621 --> 01:21:40,189 ENDOMETRIOSIS IN ADOLESCENCE OR 2049 01:21:40,189 --> 01:21:45,328 WHEN YOU FIRST START YOUR 2050 01:21:45,328 --> 01:21:45,661 PERIOD? 2051 01:21:45,661 --> 01:21:47,196 >> STACEY, YOU GO FIRST. 2052 01:21:47,196 --> 01:21:51,434 >> I WAS GOING TO SAY I'LL LET 2053 01:21:51,434 --> 01:21:57,406 SUSIE TALK ABOUT FROM THE 2054 01:21:57,406 --> 01:22:00,209 CLINICAL LENS THAT THERE ARE THE 2055 01:22:00,209 --> 01:22:02,511 ADC STUDY FRANK 2 THERE'S AN 2056 01:22:02,511 --> 01:22:04,914 INCREASING ATTENTION ON 2057 01:22:04,914 --> 01:22:09,318 PREDICTORS OF BIOMARKERS, PANEL 2058 01:22:09,318 --> 01:22:15,324 WAYS, PREDICTORS OF DYSMENORRHEA 2059 01:22:15,324 --> 01:22:18,928 BEFORE OR SOON AFTER ONSET AND 2060 01:22:18,928 --> 01:22:20,896 DISCOVERING INDICATIONS IN LATE 2061 01:22:20,896 --> 01:22:25,334 CHILDHOOD AND EARLY ADOLESCENCE 2062 01:22:25,334 --> 01:22:27,470 THAT SEEM TO BE INDICATIVE OF 2063 01:22:27,470 --> 01:22:29,438 THE LIKELIHOOD OF EXPERIENCING 2064 01:22:29,438 --> 01:22:32,174 NOT JUST DYSMENORRHEA BUT LIFE 2065 01:22:32,174 --> 01:22:33,843 IMPACTING THEMES AND THE NEXT 2066 01:22:33,843 --> 01:22:37,413 QUESTION IS, IS THAT THEN 2067 01:22:37,413 --> 01:22:41,384 PREDICTIVE OF DEVELOPMENT OF 2068 01:22:41,384 --> 01:22:42,084 CHRONIC PELVIC PAIN. 2069 01:22:42,084 --> 01:22:45,354 AND THE WINDOWS OF CRITICAL 2070 01:22:45,354 --> 01:22:46,889 EXPOSURE AND IT'S EXCITING 2071 01:22:46,889 --> 01:22:48,924 RESEARCH SHOWING INDICATIONS 2072 01:22:48,924 --> 01:22:50,359 THAT HOPEFULLY AGAIN WE CAN 2073 01:22:50,359 --> 01:22:51,060 UNDERSTAND MORE ABOUT THE 2074 01:22:51,060 --> 01:22:53,229 BIOLOGY WHICH MEANS THEN WE CAN 2075 01:22:53,229 --> 01:22:54,463 UNDERSTAND BETTER HOW TO TARGET 2076 01:22:54,463 --> 01:22:56,332 AND INTERVENE UPON IT. 2077 01:22:56,332 --> 01:22:59,502 SUSIE, DO YOU WANT TO SPEAK TO 2078 01:22:59,502 --> 01:23:02,371 PREVALENCES AND THE CLINICAL 2079 01:23:02,371 --> 01:23:03,672 PATHWAY? 2080 01:23:03,672 --> 01:23:06,409 >> WHAT YOU ARE BOTH SAYING IS 2081 01:23:06,409 --> 01:23:07,510 INCREDIBLY IMPORTANT AS WELL 2082 01:23:07,510 --> 01:23:08,010 INSIGHTFUL. 2083 01:23:08,010 --> 01:23:12,415 THE ONLY THING I WOULD ADD AS A 2084 01:23:12,415 --> 01:23:13,416 CLINICIAN THOUGH IS THAT WHILE 2085 01:23:13,416 --> 01:23:17,053 THIS IS TAKING OFF OUR 2086 01:23:17,053 --> 01:23:18,587 EPIDEMIOLOGY HAT AND PUTTING ON 2087 01:23:18,587 --> 01:23:20,256 OUR CLINICIAN HAT IS WHILE MANY 2088 01:23:20,256 --> 01:23:21,924 OF THESE THINGS ARE INCREASED 2089 01:23:21,924 --> 01:23:25,394 RISK FACTORS, IT DOES NOT 2090 01:23:25,394 --> 01:23:26,996 NECESSARY PREDICT WHAT WE SEE IN 2091 01:23:26,996 --> 01:23:29,398 A GIVEN INDIVIDUAL PATIENT. 2092 01:23:29,398 --> 01:23:31,233 YES, ABSOLUTELY THE BEST WHEN 2093 01:23:31,233 --> 01:23:33,602 YOU ASK PATIENTS RETROSPECTIVELY 2094 01:23:33,602 --> 01:23:36,405 WHEN DID YOUR SYMPTOMS BEGIN, 2095 01:23:36,405 --> 01:23:39,975 THE VAST MAJORITY OF PATIENTS 2096 01:23:39,975 --> 01:23:41,544 THAT HAVE ENDOMETRIOSIS RECALL 2097 01:23:41,544 --> 01:23:44,780 THEIR SYMPTOMS BEGAN IN 2098 01:23:44,780 --> 01:23:45,181 ADOLESCENCE. 2099 01:23:45,181 --> 01:23:48,918 BUT IT'S NOT THE SAME IN 2100 01:23:48,918 --> 01:23:49,952 ADOLESCENCE WHAT PROPORTION OF 2101 01:23:49,952 --> 01:23:52,588 THOSE WHO HAVE PAINFUL LIFE 2102 01:23:52,588 --> 01:23:56,058 IMPACTING DYSMENORRHEA OR PAIN 2103 01:23:56,058 --> 01:23:59,595 WITH THEIR PERIODS HAVE 2104 01:23:59,595 --> 01:24:00,463 ENDOMETRIOSIS THAT NUMBER WE 2105 01:24:00,463 --> 01:24:01,764 DON'T ENTIRELY KNOW. 2106 01:24:01,764 --> 01:24:03,566 AS EVERYONE ON THE PANEL KNOWS 2107 01:24:03,566 --> 01:24:10,973 WE DON'T HAVE A NON-INVASIVE WAY 2108 01:24:10,973 --> 01:24:15,211 AND OUR IMAGING DOES A GOOD JOB 2109 01:24:15,211 --> 01:24:18,414 WITH ADVANCED DISEASE WHICH IS 2110 01:24:18,414 --> 01:24:28,958 RARE IN ADOLESCENCE AND UNLESS 2111 01:24:29,191 --> 01:24:32,361 THEY HAVE A LAPAROSCOPY WHAT 2112 01:24:32,361 --> 01:24:33,229 PROPORTION HAVE IT WE DON'T KNOW 2113 01:24:33,229 --> 01:24:34,530 AND ON THE FLIP SIDE I WANT TO 2114 01:24:34,530 --> 01:24:37,800 POINT OUT IF I SEE AN ADULT 2115 01:24:37,800 --> 01:24:40,402 WOMEN WITH NEW ONSET 2116 01:24:40,402 --> 01:24:42,471 DYSMENORRHEA OR RELATIVELY NEW 2117 01:24:42,471 --> 01:24:43,139 DYSMENORRHEA THAT STARTED LATER 2118 01:24:43,139 --> 01:24:45,674 IN LIFE, DOES THAT MEAN SHE'S 2119 01:24:45,674 --> 01:24:48,978 LESS LIKELY TO HAVE ENDO? 2120 01:24:48,978 --> 01:24:50,045 ABSOLUTELY NOT. 2121 01:24:50,045 --> 01:24:52,014 WE SHOULD BE EVALUATING THOSE 2122 01:24:52,014 --> 01:24:53,582 PATIENTS WITH EQUAL LEVEL OF 2123 01:24:53,582 --> 01:24:55,684 SENSITIVITY AND CARE THAT THAT 2124 01:24:55,684 --> 01:25:00,222 IS A POSSIBILITY TOO AND FOR 2125 01:25:00,222 --> 01:25:01,023 MANY PATIENTS THEIR 2126 01:25:01,023 --> 01:25:02,191 ENDOMETRIOSIS JOURNEY STARTS 2127 01:25:02,191 --> 01:25:03,692 AFTER MANY YEARS OF NOT HAVING 2128 01:25:03,692 --> 01:25:05,027 PAINFUL PERIODS. 2129 01:25:05,027 --> 01:25:09,465 SO WE NEED TO CONSIDER IT IN ALL 2130 01:25:09,465 --> 01:25:17,072 OF THESE OPTIONS. 2131 01:25:17,072 --> 01:25:20,509 >> THIS QUESTION FROM THE 2132 01:25:20,509 --> 01:25:22,144 AUDIENCE BASED ON PSYCHOLOGICAL 2133 01:25:22,144 --> 01:25:25,247 TRAUMA AS A RISK FACTOR FOR 2134 01:25:25,247 --> 01:25:26,415 ENDOMETRIOSIS AND ALSO AS AN 2135 01:25:26,415 --> 01:25:28,450 OUTCOME OF ENDOMETRIOSIS. 2136 01:25:28,450 --> 01:25:30,786 HOW DOES ENDOMETRIOSIS OVERLAP 2137 01:25:30,786 --> 01:25:33,622 WITH DEPRESSION, ANXIETY AND 2138 01:25:33,622 --> 01:25:37,326 QUESTIONS LIKE THAT? 2139 01:25:37,326 --> 01:25:39,028 I MIGHT START WITH SUSIE? 2140 01:25:39,028 --> 01:25:40,663 >> I THINK THAT'S GREAT. 2141 01:25:40,663 --> 01:25:45,401 I THINK STACEY'S ONE OF THE FEW 2142 01:25:45,401 --> 01:25:47,469 PEOPLE I KNOW THAT'S PUBLISHED 2143 01:25:47,469 --> 01:25:51,674 IN A PROSPECTIVE WAY, CORRECT ME 2144 01:25:51,674 --> 01:25:57,413 IF I'M WRONG, STACEY ABOUT 2145 01:25:57,413 --> 01:25:59,715 DIAGNOSIS WITH ENDO AND LET HER 2146 01:25:59,715 --> 01:26:01,517 RESPOND BUT WHAT I THINK IS 2147 01:26:01,517 --> 01:26:03,986 IMPORTANT TO POINT OUT BROADLY 2148 01:26:03,986 --> 01:26:06,355 TO PATIENTS IS THAT I THINK ONE 2149 01:26:06,355 --> 01:26:07,790 OF THE MOST CHALLENGING THINGS 2150 01:26:07,790 --> 01:26:10,826 TO EXPLAIN IS I NEVER EVER WANT 2151 01:26:10,826 --> 01:26:13,295 A PATIENT TO GO AWAY FROM A 2152 01:26:13,295 --> 01:26:16,799 CLINICAL VISIT WITH THE 2153 01:26:16,799 --> 01:26:17,866 IMPRESSION THAT I THINK THE PAIN 2154 01:26:17,866 --> 01:26:22,571 IS ALL IN HER HEAD OR IF THEY 2155 01:26:22,571 --> 01:26:24,640 HAVE DEPRESSION OR ANXIETY, THAT 2156 01:26:24,640 --> 01:26:27,676 IT IS WHAT IS CAUSING THEM TO BE 2157 01:26:27,676 --> 01:26:29,411 IN PAIN. 2158 01:26:29,411 --> 01:26:31,280 WE KNOW WITH AN OVERWHELMING 2159 01:26:31,280 --> 01:26:32,615 AMOUNT OF PROSPECTIVE DATA THAT 2160 01:26:32,615 --> 01:26:35,017 FOR THE MAJORITY OF PATIENTS WHO 2161 01:26:35,017 --> 01:26:37,319 SUFFER FROM CHRONIC PAIN THE 2162 01:26:37,319 --> 01:26:41,090 MOOD DISORDERS COME AS A 2163 01:26:41,090 --> 01:26:42,658 CONSEQUENCE OF UNTREATED PAIN 2164 01:26:42,658 --> 01:26:44,393 AND THE PROPORTION THAT START 2165 01:26:44,393 --> 01:26:47,062 WITH MOOD DISORDERS AND GO ON TO 2166 01:26:47,062 --> 01:26:48,797 CHRONIC PAIN IS A SMALLER 2167 01:26:48,797 --> 01:26:49,265 PROPORTION. 2168 01:26:49,265 --> 01:26:51,967 BEING CLEAR TO DISTINGUISH THAT 2169 01:26:51,967 --> 01:26:53,402 IS INCREDIBLY IMPORTANT HOWEVER 2170 01:26:53,402 --> 01:26:56,639 WE DO KNOW THAT UNTREATED MOOD 2171 01:26:56,639 --> 01:26:57,373 DISORDERS MAKES IT VERY 2172 01:26:57,373 --> 01:26:59,108 DIFFICULT TO MANAGE AND IMPROVE 2173 01:26:59,108 --> 01:27:01,410 PAIN AND SO WE NEED TO TREAT 2174 01:27:01,410 --> 01:27:04,980 THOSE SIMULTANEOUSLY TO IMPROVE 2175 01:27:04,980 --> 01:27:06,215 PATIENTS QUALITY OF LIFE BUT NOT 2176 01:27:06,215 --> 01:27:08,484 BECAUSE WE THINK WE'RE 2177 01:27:08,484 --> 01:27:09,918 SPECIFICALLY TREATING THE 2178 01:27:09,918 --> 01:27:11,353 ENDOMETRIOSIS OR UNDERLYING 2179 01:27:11,353 --> 01:27:13,022 CONDITION BUT I'LL LET STACEY 2180 01:27:13,022 --> 01:27:16,125 TALK ABOUT THAT ONE PAPER OR 2181 01:27:16,125 --> 01:27:16,759 WHATEVER, SORRY. 2182 01:27:16,759 --> 01:27:18,427 >> THANK YOU, SUSIE. 2183 01:27:18,427 --> 01:27:23,399 I'LL JUST ADD THAT AGAIN WITH A 2184 01:27:23,399 --> 01:27:24,466 PATIENT-CENTER AND 2185 01:27:24,466 --> 01:27:25,401 PATIENT-FACING LENS THAT THERE 2186 01:27:25,401 --> 01:27:27,836 IS AN INCREASED RISK OF BEING 2187 01:27:27,836 --> 01:27:30,139 DIAGNOSED WITH THOSE WHO HAVE A 2188 01:27:30,139 --> 01:27:33,676 HISTORY OF PHYSICAL AND 2189 01:27:33,676 --> 01:27:35,344 EMOTIONAL ABUSE DURING 2190 01:27:35,344 --> 01:27:37,279 ADOLESCENCE THAT DOES NOT BY ANY 2191 01:27:37,279 --> 01:27:39,148 MEANS EXPLAIN AWAY THEIR 2192 01:27:39,148 --> 01:27:39,748 EXPERIENCE. 2193 01:27:39,748 --> 01:27:41,050 IT CERTAINLY DOES NOT MEAN THIS 2194 01:27:41,050 --> 01:27:45,020 IS AN ALL IN THEIR HEAD 2195 01:27:45,020 --> 01:27:45,321 CONNECTION. 2196 01:27:45,321 --> 01:27:48,957 IT ALSO DOES NOT MEAN THAT THOSE 2197 01:27:48,957 --> 01:27:49,892 WITH ENDOMETRIOSIS HAVE THAT 2198 01:27:49,892 --> 01:27:50,959 HISTORY. 2199 01:27:50,959 --> 01:27:52,928 WHAT IT DOES MEAN IS AGAIN 2200 01:27:52,928 --> 01:27:55,464 COMING BACK TO WE NEED TO CARE 2201 01:27:55,464 --> 01:27:57,333 ABOUT THESE EXPERIENCES. 2202 01:27:57,333 --> 01:27:59,968 WE NEED TO BE CURIOUS ABOUT 2203 01:27:59,968 --> 01:28:01,670 THEIR BIOLOGIC IMPACT. 2204 01:28:01,670 --> 01:28:03,205 WE KNOW ENDOMETRIOSIS IS ONE OF 2205 01:28:03,205 --> 01:28:08,310 A LONG LIST OF CONDITIONS 2206 01:28:08,310 --> 01:28:11,146 INCLUDING HIGH BLOOD PRESSURE 2207 01:28:11,146 --> 01:28:14,783 AND UTERINE FIBROIDS AND A LONG 2208 01:28:14,783 --> 01:28:16,285 LIST ASSOCIATED WITH EARLY LIFE 2209 01:28:16,285 --> 01:28:16,518 TRAUMA. 2210 01:28:16,518 --> 01:28:18,754 THE LENS THEN IS PREVENTING AND 2211 01:28:18,754 --> 01:28:21,690 CARING ABOUT EARLY LIFE TRAUMA 2212 01:28:21,690 --> 01:28:23,425 AND UNDERSTANDING WHAT IT IS 2213 01:28:23,425 --> 01:28:25,761 CATALYZING SO WE CAN MINIMIZE 2214 01:28:25,761 --> 01:28:33,435 THOSE LONG-TERM HEALTH IMPACTS. 2215 01:28:33,435 --> 01:28:35,270 >> THERE'S LOTS OF QUESTIONS 2216 01:28:35,270 --> 01:28:36,438 ABOUT YOUR TECHNOLOGY AS IT'S 2217 01:28:36,438 --> 01:28:37,439 BEING DEVELOPED. 2218 01:28:37,439 --> 01:28:38,307 DO YOU WANT TO TALK A LITTLE BIT 2219 01:28:38,307 --> 01:28:42,711 ABOUT HOW IT RELATES TO SOME OF 2220 01:28:42,711 --> 01:28:44,680 THE OTHER TESTS OR GIVE A 2221 01:28:44,680 --> 01:28:46,815 LANDSCAPE REVIEW OF WHAT'S OUT 2222 01:28:46,815 --> 01:28:51,120 THERE RIGHT NOW MAYBE I CAN TALK 2223 01:28:51,120 --> 01:28:53,655 ABOUT RADX AND THE FUTURE. 2224 01:28:53,655 --> 01:28:57,993 >> THE TWO I SAW POPPED ONE WAS 2225 01:28:57,993 --> 01:29:03,665 THE IVF SETTING IS AN 2226 01:29:03,665 --> 01:29:08,404 ENDOMET 2227 01:29:08,404 --> 01:29:09,104 ENDOMET 2228 01:29:09,104 --> 01:29:09,638 ENDOMETRIAL BIOPSY AND A 2229 01:29:09,638 --> 01:29:10,572 BIOMARKER AND LEAVE IT UP TO THE 2230 01:29:10,572 --> 01:29:12,508 CLINICIANS TO TALK ABOUT HOW 2231 01:29:12,508 --> 01:29:16,078 THEY USE IT AND IT'S A MARKER OF 2232 01:29:16,078 --> 01:29:18,514 INFLAMMATION AND USED 2233 01:29:18,514 --> 01:29:21,717 INTERCHANGEABLY AS AN INDICATION 2234 01:29:21,717 --> 01:29:23,152 OF ENDOMETRIOSIS. 2235 01:29:23,152 --> 01:29:27,022 IT IS NOT A NEXT-GEN SEQUENCING 2236 01:29:27,022 --> 01:29:29,758 TEST LIKE OURS OR MENSTRUAL 2237 01:29:29,758 --> 01:29:33,829 BASED SO IT'S DIFFERENT . 2238 01:29:33,829 --> 01:29:37,433 THE OTHER IS THE SALIVA TEST 2239 01:29:37,433 --> 01:29:39,101 BEING DEVELOPED IN EUROPE. 2240 01:29:39,101 --> 01:29:43,439 I KNOW IT'S NOT IN THE U.S. 2241 01:29:43,439 --> 01:29:45,340 I THINK THEY'RE STILL COMPLETING 2242 01:29:45,340 --> 01:29:46,942 THEIR BIG TRIAL FOR THAT 2243 01:29:46,942 --> 01:29:48,210 PARTICULAR TEST AND SEE THE 2244 01:29:48,210 --> 01:29:50,078 RESULT OF THOSE TRIALS SOON. 2245 01:29:50,078 --> 01:29:53,749 AND ONE OTHER QUESTION THAT CAME 2246 01:29:53,749 --> 01:29:57,419 UP WHICH MULTIPLE PEOPLE TALKED 2247 01:29:57,419 --> 01:29:58,387 ABOUT OUR MRI SIGNATURES BY DAY 2248 01:29:58,387 --> 01:30:00,289 AND WE HAVE. 2249 01:30:00,289 --> 01:30:01,757 IT'S ONE OF THE BIGGEST THINGS 2250 01:30:01,757 --> 01:30:03,525 WE HAVE TO CONTROL FOR. 2251 01:30:03,525 --> 01:30:06,628 IT'S ALSO ONE OF THE REASONS WE 2252 01:30:06,628 --> 01:30:10,499 LIKE MENSTRUAL-BASED ASSAYS. 2253 01:30:10,499 --> 01:30:13,168 YOU'RE PASSIVELY ALIGNING WITH 2254 01:30:13,168 --> 01:30:14,970 THOSE IN THE CYCLE AND THERE'S A 2255 01:30:14,970 --> 01:30:20,209 WINDOW AND THE PERIOD LASTS 3 TO 2256 01:30:20,209 --> 01:30:21,710 7 DAYS OR WHAT HAVE YOU AND 2257 01:30:21,710 --> 01:30:24,012 THERE'S A WINDOW OF 2258 01:30:24,012 --> 01:30:25,180 INVARIABILITY AND THERE'S 2259 01:30:25,180 --> 01:30:26,782 PIPELINES WE HAVE TO BUILD TO 2260 01:30:26,782 --> 01:30:27,916 ACCOUNT FOR THAT VARIABILITY. 2261 01:30:27,916 --> 01:30:31,186 BUT I WOULD SAY WE SEE 2262 01:30:31,186 --> 01:30:31,920 VARIABILITY. 2263 01:30:31,920 --> 01:30:33,822 WE COLLECTED TAMPONS FROM PEOPLE 2264 01:30:33,822 --> 01:30:36,892 30 DAYS EVERY DAY OF THE MONTH 2265 01:30:36,892 --> 01:30:38,393 EVEN WHEN THEY'RE NOT BLEEDING. 2266 01:30:38,393 --> 01:30:40,762 I THING ONE OF THE BIGGEST 2267 01:30:40,762 --> 01:30:42,931 CHALLENGES FOR ANY TEST NOT 2268 01:30:42,931 --> 01:30:44,366 BASED ON MENSTRUATION IS STILL 2269 01:30:44,366 --> 01:30:45,834 WORTH PURSUING AND WE'RE FANS OF 2270 01:30:45,834 --> 01:30:49,171 SOME OF THESE ENDEAVORS BUT YOU 2271 01:30:49,171 --> 01:30:51,273 HAVE TO BE CAREFUL FOR WHERE 2272 01:30:51,273 --> 01:30:53,041 SOMEONE IS IN THEIR CYCLE. 2273 01:30:53,041 --> 01:30:57,446 IF YOU SEND SOMEONE FOR A BLOOD 2274 01:30:57,446 --> 01:31:01,250 OR SALIVA TEST OR BIOPSY YOU 2275 01:31:01,250 --> 01:31:02,951 HAVE INTRODUCED THIS HUGE 2276 01:31:02,951 --> 01:31:03,919 VARIABLE WHICH CAN MAKE YOUR 2277 01:31:03,919 --> 01:31:05,187 DATA MORE NOISY. 2278 01:31:05,187 --> 01:31:07,256 I THINK THOSE ARE THE ONLY TOOLS 2279 01:31:07,256 --> 01:31:08,724 I SAW COME UP. 2280 01:31:08,724 --> 01:31:10,959 WERE THERE TWO OTHERS? 2281 01:31:10,959 --> 01:31:12,694 >> THAT'S PERFECT. 2282 01:31:12,694 --> 01:31:16,632 THE FACT YOU BROUGHT US AROUND 2283 01:31:16,632 --> 01:31:24,640 TO THE FACT WOMEN WERE LEFT OUT 2284 01:31:24,640 --> 01:31:26,174 BECAUSE OF THIS COMPLEXITY OF 2285 01:31:26,174 --> 01:31:27,643 THE MENSTRUAL CYCLE AND NOW THE 2286 01:31:27,643 --> 01:31:28,343 SCIENCE IS TRYING TO FOCUS ON 2287 01:31:28,343 --> 01:31:29,745 THE COMPLEXITY AS A WAY TO LOOK 2288 01:31:29,745 --> 01:31:32,414 AT HEALTH IN A DIFFERENT WAY 2289 01:31:32,414 --> 01:31:33,582 SPECIFIC TO THAT POPULATION. 2290 01:31:33,582 --> 01:31:36,184 I THINK THAT'S A FANTASTIC WAY 2291 01:31:36,184 --> 01:31:39,321 TO END BY REALLY BRINGING US 2292 01:31:39,321 --> 01:31:42,457 AROUND TO THE INNOVATION IN THIS 2293 01:31:42,457 --> 01:31:43,625 SPACE BEING PATIENT CENTER AND 2294 01:31:43,625 --> 01:31:48,597 TRYING TO GET BACK TO THE IDEA 2295 01:31:48,597 --> 01:31:49,898 THAT NO ONE EXPERIENCES 2296 01:31:49,898 --> 01:31:51,333 ENDOMETRIOSIS IN THE SAME WAY 2297 01:31:51,333 --> 01:31:56,905 AND THE LESIONS AREN'T THE SAME 2298 01:31:56,905 --> 01:31:57,639 WAY AND NEED TO UNDERSTAND EACH 2299 01:31:57,639 --> 01:31:58,574 PATIENT. 2300 01:31:58,574 --> 01:32:01,410 I WANT TO THANK YOU ALL FOR THIS 2301 01:32:01,410 --> 01:32:02,144 PHENOMENAL PANEL. 2302 01:32:02,144 --> 01:32:03,111 YOU'VE BROUGHT DIFFERENT 2303 01:32:03,111 --> 01:32:04,846 PERSPECTIVES OF ENDOMETRIOSIS TO 2304 01:32:04,846 --> 01:32:06,748 THE REST OF US WHO DON'T ALWAYS 2305 01:32:06,748 --> 01:32:07,416 GET TO HEAR THAT. 2306 01:32:07,416 --> 01:32:09,318 THAT WAS FANTASTIC. 2307 01:32:09,318 --> 01:32:12,588 TO OUR LARGE AND PARTICIPATORY 2308 01:32:12,588 --> 01:32:13,355 AUDIENCE, THANK YOU. 2309 01:32:13,355 --> 01:32:16,391 I WILL DO MY BEST TO MAKE SURE 2310 01:32:16,391 --> 01:32:17,693 ANSWERS TO THESE QUESTIONS ARE 2311 01:32:17,693 --> 01:32:19,194 SENT OUT AFTER THE MEETING AND 2312 01:32:19,194 --> 01:32:20,929 THE RECORDING WILL BE SEND OUT 2313 01:32:20,929 --> 01:32:22,631 TO ALL REGISTRANTS AS WELL. 2314 01:32:22,631 --> 01:32:24,299 THANK YOU FOR BEING PART OF 2315 01:32:24,299 --> 01:32:24,700 THIS. 2316 01:32:24,700 --> 01:32:27,936 THANK YOU FOR BEING PART OF THE 2317 01:32:27,936 --> 01:32:28,604 CONVERSATION ON ENDOMETRIOSIS 2318 01:32:28,604 --> 01:32:30,172 AND FURTHERING THAT FOR ALL OF 2319 01:32:30,172 --> 01:32:30,372 US. 2320 01:32:30,372 --> 01:32:35,644 ON BEHALF OF NIH, THANK YOU AND 2321 01:32:35,644 --> 01:32:36,612 WE ARE COMPLETE. 2322 01:32:36,612 --> 01:32:37,446 I APPRECIATE EVERYONE'S HELP 2323 01:32:37,446 --> 01:32:37,846 BEING HERE TODAY. 2324 01:32:37,846 --> 01:32:37,913 2325 01:33:09,778 --> 01:33:19,755 S