Endometriosis is a chronic, systemic, and inflammatory disease that primarily affects women of reproductive age, and early diagnosis is essential to prevent potential complications.
It is characterized by the presence of endometrial tissue (frequently located inside the uterus) outside the uterine cavity. Endometriosis most commonly affects the pelvic area, particularly the surface of the ovaries (sometimes forming cysts), although it may also involve the intestines, bladder, and cause tissue adhesions that can affect nearby nerves.
As occurs within the uterus, these cells respond to hormonal changes during the menstrual cycle. As a result, they can lead to inflammation, pain, and other complications such as infertility.
How many women are affected by endometriosis?
Endometriosis affects approximately 10% of women of reproductive age worldwide, which corresponds to around 1G0 million women.
In Spain, it is estimated that approximately two million women are affected by this condition. However, one of the main challenges is delayed diagnosis: on average, it can take up to seven years from the onset of symptoms to confirmation.
For this reason, it is often considered a “silent disease”, with many women living with it for years without receiving an accurate diagnosis.
What are the symptoms of endometriosis?
The symptoms of endometriosis can vary significantly from one woman to another. Some patients experience severe and disabling pain that interferes with daily activities, while others may have mild symptoms or even no evident signs.
The most common symptoms include:
- Abdominal pain
- Cyclical pelvic pain (menstrual or ovulatory)
- Lower back pain
- Pain during and after sexual intercourse (dyspareunia)
- Intermenstrual bleeding
- Gastrointestinal discomfort
- Fertility problems
Additionally, many women experience extreme fatigue, digestive discomfort, or urinary issues, which can affect their quality of life, rest, work, and emotional well- being.
Types of endometriosis
There are multiple classifications of endometriosis based on different diagnostic approaches. After a thorough evaluation of symptoms, highly specialized examination, and, in some cases, surgery, the types of endometriosis can be summarized as follows:
Superficial endometriosis
Characterized by tissue retraction and anatomical changes that, despite not always producing large visible lesions, can cause significant symptoms (detectable indirectly through targeted imaging or during surgical evaluation).
Ovarian endometriosis
Cysts known as endometriomas may develop in the ovaries. A detailed assessment is required to rule out other types of endometriosis that may coexist.
Deep or infiltrating endometriosis
Presents as fibrotic nodules that may affect urinary structures (particularly the ureters), the large intestine, fallopian tubes, and ovaries, often involving multiple organs as a complex mass.
Adenomyosis
Affects the muscular wall of the uterus and may present in different forms and degrees of severity.
How is endometriosis diagnosed?
The diagnosis of endometriosis can be complex, especially in the early stages of the disease. For this reason, it is important to consult a specialist if symptoms persist.
Several medical tests may be used to confirm its presence, including:
- Targeted medical history
- Pelvic examination
- Highly specialized transvaginal ultrasound
- Magnetic resonance imaging (MRI)
- Laparoscopy (now less commonly used solely as a diagnostic tool)
Treatment of endometriosis
Endometriosis is a chronic condition, and currently there is no definitive cure. However, various therapeutic options are available to manage symptoms and improve patients’ quality of life. Pain relievers and hormonal treatments can help reduce pain and slow the activity of endometrial tissue. In selected cases that do not respond to medical treatment, surgery may be performed to remove lesions, particularly when they cause severe pain or compromise fertility.
Although treatment can control symptoms, the disease may progress over time. In many cases, symptoms improve after menopause, when hormonal activity declines.
For this reason, medical follow-up and early diagnosis are essential to properly manage
the disease and preserve patients’ quality of life.
If you have been diagnosed with endometriosis or present compatible symptoms and wish to become pregnant, consulting a specialist in assisted reproduction at Eugin can help you assess your reproductive situation and plan the next steps. An initial medical consultation allows for a personalized evaluation of your case, an assessment of how the disease may affect your fertility, and guidance on the available options to achieve pregnancy with the best possible chances.
Reviewed by Dr. Silvia Agramunt
