Endometriosis is considered a chronic disorder. Chronic disorders are those that continue over an extended period of time, lasting at least 3 months, limiting daily living or requiring medical attention.
The disease consists of endometrial tissue, which is normally located in the uterus, growing outside of it, forming endometrial lesions which cause inflammation. That is why women who suffer from it, are often in pain.
This condition affects around 10% of women in their reproductive years. The cause remains unknown, and current treatment only addresses the symptoms of this disorder, which is why medicine and research now aims to improve diagnostic methods and treatment options.
Common Symptoms of Endometriosis
Although symptoms of endometriosis can significantly vary, three of the most common are:
- Pelvic pain: Can occur at any time but normally around the menstrual cycle. It is the key symptom, and women usually describe it as cramping, aching, or sharp pain in the pelvic region. Around 42% of women with endometriosis suffer from chronic pelvic pain.
- Dysmenorrhea: Meaning painful periods, usually during menstruation, but sometimes pain appears before it. The duration of the cramps is approximately from 2 to 3 days.
- Dyspareunia: Pain during intercourse is also common in endometriosis and can have an impact on a woman’s relationships and self-image.
Other related symptoms include infertility, with around 30% to 50% of women with endometriosis suffering from fertility issues. Interestingly, some women with endometriosis have no painful symptoms, and are only diagnosed when they struggle to get pregnant and seek medical help to do so.
Another common symptom is heavy menstrual bleeding. Recent research highlights the role of chronic remodeling of the nervous system in inducing persistent pain, with inflammatory responses being triggered by bleeding from endometrial lesions leading to sensitization and chronic pain.
Despite the knowledge about these symptoms, they are not specific to endometriosis and can be misdiagnosed. Diagnosing can also be complicated by the fact that symptoms may vary from woman to woman. Reaching a definitive diagnosis for these patients can be an incredibly long process, taking an average of almost 7 years.

How is Endometriosis Diagnosed?
The average age of diagnosis of endometriosis is around 28 years old; diagnosis is often complicated since symptoms may mirror those of other conditions. Methods used to identify or to confirm the condition are:
- Pelvic examination: A gynecologist may check for abnormalities or cysts, although this often does not confirm the diagnosis.
- Imaging tests (pelvic ultrasound or MRI): Can reveal possible endometriosis areas.
- Laparoscopy: Consists of a surgical procedure that allows a direct view of the inside of the pelvis.
- Biopsy: Commonly performed during laparoscopy. This method is to confirm endometriosis by examining tissue under a microscope.
Differential Diagnosis of Endometriosis: Adenomyosis, Fibroids, and More
Endometriosis and uterine fibroids are common conditions affecting women of reproductive age, resulting in both often coexisting.
Uterine fibroids or myomas are non-cancerous growths that form in or on the uterus walls. These growths are made of muscle and connective tissue, varying in size, number and location. Women suffering from myomas can have just one myoma or multiple.
Approximately 86% of women with uterine fibroids have associated endometriosis.
These two conditions can cause pelvic pain, heavy menstrual bleeding, infertility, and other symptoms, making differential diagnosis challenging.
Several studies suggest that the presence of uterine fibroids increases the risk of developing endometriosis, and the other way around. Patients with coexisting conditions of fibroids and endometriosis tend to have more severe pelvic pain and similar effects on fertility compared to those without endometriosis.
If surgery is being considered to treat one of the conditions, it may be beneficial to consider surgery for both at the same time to avoid repeated procedures.
The mechanism that results in these associated conditions is still unknown.
Another condition that can be confused with endometriosis is adenomyosis, which consists of endometrial tissue growing inside the muscular wall of the uterus. Common symptoms are heavy menstrual bleeding, pelvic pain and dysmenorrhea, very similar to those seen with endometriosis.
The cause of adenomyosis is also unknown, and it is commonly found in women that are being assessed for endometriosis, pelvic pain or uterine fibroids.

Treatment Options for Endometriosis
Since no cure exists for this condition, treatments focus on improving quality of life, reducing pain and also decreasing the growth of misplaced tissue, or even the removal of it.
In addition, women with desire for getting pregnant, as this condition may cause infertility, often use assisted reproductive techniques.
Therapies to treat endometriosis can include:
- Pain management: Over-the-counter pain relief.
- Hormonal therapy: Birth control pills and progestins can help regulate menstruation, which reduce or eliminate symptoms for some women.
- Surgery: Laparoscopic surgery can remove or destroy endometrial lesions, providing temporary relief. However, the condition can return after surgery, requiring further treatment.
- Lifestyle Adjustments: Dietary changes, physical therapy, and regular exercise can help some women manage their symptoms.
Selecting a treatment plan depends on factors like symptom severity, age, and desire for pregnancy. In more severe cases, a multidisciplinary approach involving gynecologists, pain specialists, and dietitians may be beneficial.
Latest Medical Advancements in Endometriosis Diagnosis and Treatment
Significant research is underway to improve endometriosis diagnosis and treatment. Some promising advances include:
- Biomarker Testing: Researchers are studying biomarkers that could potentially diagnose endometriosis through a blood test, reducing the need for invasive laparoscopy.
- New Hormonal Therapies: Recently approved drugs reduce symptoms without the side effects of traditional hormonal therapies.
- Non-Invasive Imaging: Improved MRI technology and ultrasound techniques offer the possibility of more accurate, non-invasive diagnostics.
- Artificial Intelligence: Combined with imaging technologies may further enhance diagnosis and detection of endometriosis-related pathology contributing to infertility.
These advancements hold promise in making diagnosis quicker, treatment less invasive, and symptom relief more sustainable for those affected by endometriosis.
Endometriosis and Cancer
Research has shown a potential link between endometriosis and certain cancers, particularly ovarian cancer.
Women with endometriosis are believed to have a higher risk of developing ovarian cancer, although this risk remains relatively low overall.
The exact reason behind this link is not fully clear but a possible association with the chronic inflammation seen in endometriosis is being investigated. Inflammation can cause cellular changes over time, potentially leading to malignancy. Additionally, genetic mutations found in cells from endometrial lesions may increase cancer susceptibility in some women.
Despite the low risk, women with endometriosis should be checked in regular gynecological visits to monitor any potential signs of cancer. Awareness of these risks has prompted further research into treatments that address both endometriosis and cancer risk factors.
Conclusion
Endometriosis is a complex and often debilitating condition affecting millions of women worldwide. While challenges remain in timely diagnosis and effective treatment, recent advances are offering new hope.
Also, increased awareness and ongoing research into this disease and its potential link to cancer will be essential in improving patient outcomes and quality of life.
For women affected by endometriosis, appropriate diagnosis, exploring all treatment options, and staying informed about new developments in the field are vital steps toward managing the condition.