TL;DR:
- Endometriosis: A gynecological disease where endometrium-like cells grow outside the uterus, causing inflammation, pain, and infertility. Affects 6-10% of women of reproductive age, often diagnosed between ages 30-50 but can occur earlier or after menopause.
- Causes: Likely genetic, environmental, autoimmune, or hormonal factors (e.g., retrograde menstruation).
- Symptoms: Severe pelvic pain, painful menstruation/intercourse, infertility, abdominal bloating, bowel issues, hematuria, depression, and fatigue. Can occasionally present as chest pain, hemoptysis, or misdiagnosed IBS.
- Diagnosis: Based on clinical symptoms, gynecological exams, imaging (ultrasound, MRI, laparoscopy), and biopsy.
- Treatment: Pharmacotherapy (hormonal drugs, contraceptives), surgery (removal of lesions, possibly uterus/ovaries), combined therapies.
- Diet: Reduce meat, trans fats, and gluten; increase fruits, vegetables, and antioxidants.
- Complications: Can lead to organ damage, infertility, intestinal obstructions, and life-threatening emergencies if untreated.
As a result of progressive climate change and genetic problems, more and more women are facing gynecological diseases. One of them is endometriosis, which very negatively affects the patient's quality of life and is one of the most common causes of infertility. The problem is so serious because the initial symptoms of the condition are very often underestimated by ladies. This, in turn, significantly delays diagnosis and reduces the effectiveness of therapy.
Endometriosis – what is it?
Endometriosis is one of gynecological diseases, in the course of which cells of the endometrium (endometrial cells) are also found outside the uterine cavity. They resemble endometrial cells in their structure and are characterized by secretory activity. They are also distinguished by their high sensitivity to various hormonal changes that occur during the menstrual cycle. This, in turn, is a direct cause of chronic inflammation. The uterine cavity inside is lined with a special tissue (endometrium). Its thickness and structure are constantly undergoing regular changes due to the hormones of the menstrual cycle. During menstruation, it is the endometrium that flakes off and is expelled along with menstrual blood. During endometriosis, many clusters of endometrium-like cells can be seen outside the uterine cavity. Typically, endometriosis conditions develop on the fallopian tubes, ligaments surrounding the uterus and outside the uterus. Also common is endometriosis on the ovary, which affects the majority of affected women. To date, the mechanism for the development of this disease has yet to be clearly explained. However, it is believed that genetic, environmental, autoimmune, allergic and epigenetic factors are responsible for it. The process of occurring endometriosis is explained by the occurrence of retrograde menstruation – a phenomenon when menstrual blood penetrates into the peritoneal cavity through the fallopian tubes. This phenomenon results in the implantation of exfoliated endometrial cells. However, retrograde menstruation also occurs in ladies without endometriosis. That is why it cannot be considered the only cause of the disease. It is estimated that endometriosis occurs in roughly 6 – 10% of women of reproductive age and is the most common cause of infertility. It is also associated with severe discomfort of the intimate areas, pain and a decrease in the quality of a woman's functioning. Diagnosis is most common between the ages of 30 and 50, although the beginnings of the development of this disease can occur much earlier. Endometriosis affects both ladies of childbearing age and after menopause. It is also detected in girls before the appearance of their first period.
Endometriosis and pregnancy
Endometriosis can effectively make it difficult to get pregnant, as women who suffer from it usually take longer to enjoy conception. In more severe stages, surgery or assisted reproductive techniques may be required for conception. It has also been noted that endometriosis is a much more common condition in infertile women. Patients with grade 1 and 2 endometriosis after the age of 35 can treat the condition through intrauterine insemination with ovulation stimulation. When therapy is unsuccessful, in vitro fertilization is proceeded with. Women with the most severe form of endometriosis, on the other hand, must undergo in vitro fertilization.
Endometriosis – diagnosis
The condition is distinguished by the fact that it can have various symptoms. The diagnosis of endometriosis is usually directly related to the gynecological ultrasound examination. During it, the doctor can detect endometrial cysts, which occur in the ovaries. Experienced specialists are also able to detect possible adenomysis – the presence of endometrial cells between fibroids of the uterine muscle. This type of condition is distinguished by painful, increased menstrual bleeding and infertility. Endometriosis, on the other hand, which presses deeply on the intestines, causes narrowing of its wall. Diagnosis is then related to both ultrasound and CT colonography and MRI. Ultrasound also allows detection of tumors within the bladder wall. The disease is usually diagnosed by analyzing clinical symptoms, palpation gynecological examination, imaging studies and CT scans. Specialists also use imaging to determine the condition during surgical intervention, which is confirmed by endometrial biopsy. It is much more difficult to diagnose superficial endometriosis. This is when doctors recommend laparoscopy. During the diagnosis, the mobility of the uterus, ovaries and intestines can be assessed. If the doctor does not notice the so-called sliding of the intestines along the wall of the uterus, then he can determine the presence of adhesions and order additional tests. For gynecological examinations, the doctor primarily evaluates the position, size and mobility of the uterus. The mobility of the adnexa, the sacro-uterine ligament and the rectovaginal septum are also taken into account. The latter two are assessed by simultaneous transvaginal and rectal examination. The examination is particularly recommended to be performed during menstruation, as it then increases the chance of detecting foci of deeply infiltrating endometriosis.
Endometriosis – symptoms
The most common symptom of endometriosis is very severe pain that occurs in the small pelvic area. Ladies may also complain of painful menstruation, unpleasant sensations during sexual intercourse, pain during urination, abdominal pain and sacral pain. In rare cases of pulmonary endometriosis, there is also temporary hemoptysis. Symptoms of endometriosis can also be related to the lower gastrointestinal tract – bloating, diarrhea, or a urge to urinate. The condition is dangerous in that it is often asymptomatic and is diagnosed by accident. Many women discover problems with endometriosis as a result of reduced fertility. Then we can talk about psychiatric symptoms of endometriosis in the form of weakness, irritability and depressive states resulting from unsuccessful attempts to get pregnant. Women who notice sudden menstrual pain in themselves should also pay special attention to diagnosis for endometriosis. In such situations, it is advisable to proceed with the diagnosis as soon as possible, as this allows for better treatment results. endometriosis symptoms infographic can be used by adding source.
What are the unusual symptoms of endometriosis?
Atypical endometriosis symptoms are caused by endometrial foci located outside the uterus and its immediate surroundings – the ovaries and fallopian tubes. Lesions in the vagina or vulva can cause recurrent bleeding, which is triggered by even the slightest mechanical irritation or infection. Endometrial foci in the ureters, bladder or urethra can, in turn, cause persistent hematuria, or pain during urination. Abnormalities associated with the location of the endometrium are also seen in the walls of the intestine. Their periodic expansion causes minor bleeding, lower abdominal pain, which is aggravated when coughing and sneezing. Patients with endometriosis may also have a problem with pain that localizes in the lumbar spine and radiates to the lower limbs or vulva. Endometriosis can occur when there has been mechanical contamination of the wound in the shells. This results, for example, from a cesarean section or classic surgeries in the lower abdominal area. Fragments of endometrium in extensive organs, can also cause such unusual symptoms as persistent cough with hemoptysis, headaches or neurological symptoms. Women experiencing bladder problems, the need to urinate frequently during periods or urinary incontinence, may also struggle with endometrium located in the bladder. Patients may also struggle with severe bloating during menstruation. Women often describe this situation and compare the size of their abdomen to the onset of pregnancy. Endometriosis in such a case is mistakenly confused with irritable bowel syndrome, as its symptoms can be similar. In addition to bloating, however, women also experience diarrhea, constipation and nausea. As an insidious disease, endometriosis also causes severe pain in the chest, shoulders or shoulder area. This occurs when endometriosis is localized in the diaphragm area. When, on the other hand, the lesion is located in the intestines and peritoneum, then a sensation of heartburn and reflux may occur. These symptoms usually occur in conjunction with typical gastrointestinal complaints.
Typical symptoms of endometriosis
The most common symptoms of endometriosis are primarily painful symptoms in the lower abdominal area during menstruation and ovulation. Women also complain of discomfort during intercourse and reduced fertility. This is because endometriosis reduces affects the regularity of ovulation and fertilization and increases the risk of miscarriage.
How and where to treat endometriosis?
Many women who have noticed symptoms in themselves that may indicate the presence of this condition ask themselves "where to treat endometriosis?". There are many options, depending on the type of disease. Usually pharmacological, surgical or combined methods are used. In the case of pharmacotherapy, the doctor administers drugs to induce menstruation and create a state of hypoestrogenism. Theoretically, such measures should prevent endometrial proliferation and promote the renewal of lesions. Pharmacological treatment consists of hormonal contraceptives, gonadotropin-releasing hormone analogs and aromatase inhibitors. Contraceptive pills for endometriosis are also one of the more popular preparations for relieving painful periods. Medications can be used cyclically and continuously. One of the ways to treat this disease, are also surgical treatments. Indications for surgical treatment include pelvic pain, infertility, deeply infiltrating endometriosis and endometrial cysts of the ovaries. Conservative treatment is also used to reduce pain and the risk of recurrence. The aim of such measures is primarily to reduce the foci of the disease, as well as to restore the normal anatomical conditions of pelvic organ function. However, the excision of endometriotic foci is a rather difficult activity that requires great skill. That is why interventions of any kind should be performed in specialized clinics by experienced personnel. Conservative treatment is especially recommended for infertile women with a low intensity of the disease. In severe stages of the disease, the doctor may order radical surgical therapy by removing the uterus with the ovaries. The task of such measures is primarily to induce surgical menopause.
Endometriosis – diet
Treatment of endometriosis can also be assisted by a proper diet combined with exercise. It is recommended to include more fruits and vegetables in the diet, and limit meat. Fruits and vegetables are a source of valuable antioxidants and beta-carotene. Significant health improvements have also been noted as a result of excluding trans fats responsible for increasing pro-inflammatory effects from the diet. Scientific studies have also shown that ladies with endometriosis experience much less pain after eliminating wheat from their diets.
What does untreated endometriosis lead to?
** Untreated endometriosis** or poorly selected therapy can cause many complications that worsen a woman's daily comfort. Using properly implemented treatment, patients can halt the course of the disease or at least slow down its development. Endometriosis is a progressive disease and can contribute to the slow degeneration of organs. Inflammation, on the other hand, is a direct cause of peritoneal irritation, as well as the occurrence of adhesions. Untreated endometriosis is also the cause of irreversible anatomical changes, which include, for example, intestinal obstruction and disruption of the intestines, or obstruction of the fallopian tubes. In rare cases, there is also an immediate threat to the patient's life. Late diagnosis and negligence can force a woman to have a stoma, removal of the ovaries, fallopian tubes and sometimes even a complete hysterectomy.
Conclusion
Endometriosis is a serious, often overlooked condition that affects many women worldwide. It causes intense pain, impacts fertility, and can significantly lower quality of life. Timely diagnosis and tailored treatments, such as medication, surgery, or lifestyle adjustments, are critical for managing this disease. Ignoring endometriosis can lead to severe complications, including organ damage or infertility. If you suspect symptoms, don't wait—early intervention improves outcomes. Educating yourself and seeking expert care are the best steps toward relief and healthier living. This condition demands attention, action, and ongoing awareness to improve lives and reduce its long-term impact.
