Endometriosis
A chronic but manageable gynecological condition
What is endometriosis?
Endometriosis is a chronic condition in which tissue similar to the endometrium—the inner lining of the uterus—grows outside the uterus, typically in the pelvic cavity. These endometrial-like cells can be found on the ovaries, fallopian tubes, outer uterine surface, bowel, or peritoneum, causing inflammation and the formation of adhesions or cysts.
Although benign, endometriosis can lead to significant pain, fertility issues, and reduced quality of life. Fortunately, early diagnosis and personalized treatment options can greatly improve a patient’s well-being and long-term outlook.
What causes endometriosis
The exact cause of endometriosis remains unknown, but several contributing factors have been identified through clinical research. Retrograde menstruation refers to menstrual blood that flows backward through the fallopian tubes into the pelvic cavity instead of exiting through the vagina. Additionally, genetic predisposition plays a significant role, as women with a family history of endometriosis are more likely to develop the condition.
Immune system dysfunction may also contribute, allowing the body to fail in eliminating misplaced endometrial-like cells, which then implant and grow. Lastly, lymphatic or hematogenous spread may explain how endometrial cells travel through the blood or lymphatic system to distant areas.
What are the main symptoms
Dysmenorrhea (painful periods)
Severe cramping and pelvic pain during menstruation, often unrelieved by over-the-counter painkillers.
Dyspareunia (pain during intercourse)
Discomfort during or after sex, especially with deep penetration, may indicate lesions near the vagina or rectovaginal space.
Infertility
Endometriosis can alter the pelvic anatomy or interfere with ovarian and tubal function, affecting fertility.
Pain during urination or bowel movements
Especially during menstruation, if the bladder or bowel are affected.
How endometriosis is diagnosed
Diagnosis requires a combination of clinical evaluation, imaging techniques, and in some cases, surgical investigation. The initial step involves a detailed medical history and pelvic examination, where patient-reported symptoms and physical findings guide further testing.
A pelvic ultrasound or transvaginal scan can reveal ovarian endometriomas (chocolate cysts) or suggest the presence of adhesions. In complex cases, Magnetic Resonance Imaging (MRI) provides detailed mapping of deep infiltrating endometriosis. However, a definitive diagnosis is achieved through diagnostic laparoscopy, a minimally invasive surgery that allows direct visualization and biopsy of endometrial implants.
What are the treatment options
Endometriosis is a complex yet manageable condition. With timely diagnosis, evidence-based treatment, and emotional support, women can regain control over their health and lead fulfilling lives. Awareness is the first step toward relief, empowerment, and healing.