Endometriosis is a gynecological condition in which tissue similar to the endometrium—the lining of the uterus—grows outside the uterus, on the ovaries, the fallopian tubes, or the pelvic tissue. These implants respond to hormones in the menstrual cycle, causing inflammation, adhesions, and sometimes the formation of cysts called endometriomas. Affecting approximately 10% of women of childbearing age according to the WHO, endometriosis remains all too often underdiagnosed, with an average delay of several years between the first symptoms and diagnosis.
Symptoms vary considerably from one woman to another, and their intensity does not always reflect the extent of the lesions. The most characteristic signs are severe pelvic pain, especially during painful periods and sexual intercourse. Pain during urination or bowel movements that occurs during menstruation, heavy menstrual bleeding, and chronic fatigue round out the picture. Infertility is sometimes the primary warning sign, revealing silent endometriosis.
The diagnosis is based on a series of tests. Transvaginal pelvic ultrasound and MRI allow for the visualization of accessible lesions and ovarian endometriomas. Laparoscopy remains the gold standard for confirming the diagnosis: this minimally invasive surgical procedure allows for direct visualization of pelvic lesions and the removal of tissue samples for histological analysis. A diagnostic delay of 6 to 10 years is common, underscoring the importance of seeking medical attention as soon as atypical menstrual pain begins.
Treatment is tailored to the severity of symptoms, the extent of the lesions, and the patient’s desire to become pregnant. Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain during acute episodes. Hormonal therapies—the continuous birth control pill, progestins, and GnRH agonists—reduce or suppress menstruation and limit the progression of lesions. Surgery to remove endometriotic implants significantly improves symptoms and fertility in moderate to severe cases. These approaches can be combined depending on the patient’s profile.
To date, there is no definitive cure forendometriosis. Available treatments aim to control symptoms, limit the progression of lesions, and preserve fertility. The disease often progresses in cycles, with periods of remission and flare-ups. A complementary approach—an anti-inflammatory diet rich in omega-3s and turmeric, along with reducing refined sugars—can support medical management by limiting systemic inflammation.
Endometriosis is implicated in approximately 30 to 50 percent of cases of female infertility. There are multiple mechanisms involved: tubal adhesions, impaired egg quality, and a pro-inflammatory pelvic environment. However, many women with endometriosis conceive spontaneously. For those experiencing difficulties, prior surgical removal of endometrial tissue can improve outcomes, and IVF remains an effective option. It is recommended to consult a fertility specialist as soon as concerns arise.
Endometriosis profoundly affects quality of life. Chronic pain limits professional and social activities, disrupts sleep, and leads to cumulative fatigue. The emotional impact is considerable: anxiety, depression, and feelings of isolation are common, amplified by a lack of recognition of the condition. Psychological counseling, support groups, and multidisciplinary care addressing pain, fertility, and mental health significantly improve patients’ quality of life.
During pregnancy, the absence of menstrual cycles can temporarily reduce endometriotic lesions and associated pain. However, this benefit is temporary: symptoms generally return after childbirth and the resumption of menstrual cycles. Pregnant women with endometriosis require close obstetric monitoring, as the condition may be associated with a slightly increased risk of obstetric complications. Appropriate medical treatment may be considered postpartum to prevent recurrence.
