Endometriosis

About Endometriosis

Endometriosis affects approximately 190 million women of reproductive age worldwide, approximately 10 percent. It occurs when tissue similar to the endometrium uterine lining grows outside the uterus, typically on the ovaries, fallopian tubes, and pelvic peritoneum. This tissue responds to hormonal cycles, causing inflammation, pain, and scarring. Symptoms include severe menstrual pain dysmenorrhea that is disproportionate to what is considered normal, chronic pelvic pain, pain with intercourse dyspareunia, pain with bowel movements or urination during menstruation, heavy menstrual bleeding, and infertility. Approximately 30 to 50 percent of women with infertility have endometriosis. The disease often goes undiagnosed for 7 to 10 years due to symptom normalization and diagnostic challenges. Diagnosis is suspected clinically and confirmed by laparoscopy with biopsy, though imaging ultrasound with specialized techniques, MRI can identify endometriomas. Treatment depends on symptoms and fertility goals. Pain management includes NSAIDs and hormonal therapies combined oral contraceptives, progestins, GnRH agonists leuprolide, and the levonorgestrel IUD Mirena. Laparoscopic excision surgery removes endometriotic implants. For infertility, surgical treatment, controlled ovarian stimulation with IUI, or IVF may be needed. Endometriosis is a chronic condition requiring long term management.