What is endometriosis?

What is endometriosis? Endometriosis is one of the most common gynecological diseases and, at the same time, one of the most misunderstood. It is estimated that around 10% of women of reproductive age suffer from it, although many of them go years without receiving a proper diagnosis.

Despite its great impact on physical, emotional and reproductive health, endometriosis continues to be considered an “invisible disease”, because its symptoms are often normalized or confused with menstrual discomfort.

What is endometriosis?

Endometriosis is a chronic, inflammatory disease in which tissue very similar to the Endometrium, the layer that lines the inside of the uterus, grows in places where it shouldn't be. This tissue can be found in the ovaries, fallopian tubes, peritoneum and, in some cases, even in neighboring organs such as the bladder or intestine.

Although this tissue is outside the uterus, it continues to respond to the hormones of the menstrual cycle, which causes inflammation, pain, internal bleeding and the formation of adhesions. Over time, these changes can cause disabling pain, digestive problems, discomfort during sexual intercourse, and difficulty achieving pregnancy.

Why does endometriosis occur?

The exact cause is not yet fully defined, but there are several theories:

Retrograde menstruation, where part of the menstrual flow travels into the pelvic cavity instead of out of the body.
Genetic factors, since it is more common in women with diagnosed direct relatives.
Immunological alterations, which could allow this abnormal tissue to survive outside the uterus.
Coelomic metaplasia, a process in which certain tissues are transformed into endometrial tissue.

The most accepted thing today is that endometriosis is a multifactorial disease, influenced by genetic predisposition, hormones and immunology.

What are the most common symptoms?

Chronic pelvic pain
Very painful menstruations
Pain during sexual intercourse
Discomfort when having a bowel movement or urinating
Difficulty conceiving

It is important to highlight that the intensity of the pain does not reflect the severity of the disease. Some women with small lesions suffer severe pain, while others with advanced lesions may have few symptoms.

Endometriosis and infertility

Between 30% and 50% of women with endometriosis have some degree of infertility. This may be due to:

Inflammation in the pelvic environment.
Alterations in the function of the fallopian tubes.
Presence of adhesions that affect the organ mobility.
Changes in ovarian quality or ovulation.

Still, many women with endometriosis achieve pregnancy with medical support, either through fertility treatments or conservative surgery.

How endometriosis is diagnosed

Diagnosis can be challenging and, on average, can take several years. Although laparoscopy remains the gold standard to confirm it, there are very useful studies that help detect signs of the disease:

Specialized transvaginal ultrasound
MRI

Early diagnosis can reduce pain, slow progression and improve quality of life.

3 treatment options

Treatment is chosen according to symptoms, age, reproductive desire and extent of the disease. The main options include:

Medical treatment with contraceptives, progestogens or drugs that act on hormones.
Surgical treatment, which can be conservative or more extensive depending on each case.
Expectant treatment, recommended in mild cases for those seeking a spontaneous pregnancy.

Each case must be evaluated individually to avoid risks, such as reduced ovarian reserve after certain surgeries.

The Endometriosis is a complex, chronic and often underdiagnosed disease, but with proper management, women who suffer from it can regain their well-being and reproductive health. The key is personalized care, early diagnosis and a treatment plan adapted to the needs of each patient.

Talking openly about endometriosis is essential to make it visible and offer more women the opportunity to receive the care they deserve.

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What is endometriosis?