Endometriosis
Understanding and Managing Endometriosis
Endometriosis is a chronic, estrogen-dependent inflammatory condition characterized by the presence of endometrial-like tissue outside the uterine cavity, most commonly involving the ovaries, pelvic peritoneum, and, less frequently, distant organs. It affects approximately 1 in 10 women of reproductive age and is a leading cause of chronic pelvic pain and infertility.
The pathophysiology of endometriosis involves a complex interplay of retrograde menstruation, immune dysfunction, angiogenesis, and genetic and epigenetic factors. Clinically, patients may present with dysmenorrhea, dyspareunia, dyschezia, and cyclic or acyclic pelvic pain. However, symptom severity does not always correlate with disease burden, which can make diagnosis challenging.
Definitive diagnosis is traditionally established via laparoscopy with histologic confirmation, though advances in imaging and the recognition of characteristic sonographic findings have improved noninvasive diagnostic capabilities. Management is individualized and may include hormonal therapies—such as combined oral contraceptives, progestins, or GnRH analogs—to suppress ectopic endometrial activity and alleviate symptoms. Surgical intervention may be warranted in cases of refractory pain, severe disease, or infertility.
Endometriosis is a chronic condition with a variable course, requiring a multidisciplinary approach that may involve gynecology, pain management, fertility specialists, and mental health support. Early diagnosis and tailored treatment can significantly improve quality of life and long-term outcomes.
When to Seek Help
If you experience severe menstrual cramps, pelvic pain between periods, pain during intercourse or bowel movements, or have difficulty conceiving, it’s important to seek medical evaluation.
Early diagnosis and intervention can help manage symptoms, preserve fertility, and improve your overall quality of life through a personalized treatment plan.