Understanding Endometriosis: Causes, Symptoms, Diagnosis, and Treatment

The exact cause of endometriosis remains unclear. Several theories have been proposed:

Retrograde menstruation (Sampson’s theory): Menstrual blood flows backward through the fallopian tubes into the pelvic cavity.

Coelomic metaplasia: Transformation of peritoneal cells into endometrial tissue.

Immune dysfunction and genetic factors may also contribute.

Common symptoms include:

Pelvic pain, especially during menstruation (dysmenorrhea)

Chronic pelvic pain

Pain during intercourse (dyspareunia)

Pain with bowel movements or urination

Infertility

Fatigue, bloating, and gastrointestinal symptoms

The severity of symptoms does not always correlate with the extent of disease.

Diagnosis is based on a combination of clinical symptoms, imaging, and surgical evaluation:

Pelvic exam may reveal tender nodules or pelvic mass.

Transvaginal ultrasound and MRI can detect ovarian endometriomas.

Laparoscopy remains the gold standard for definitive diagnosis and staging.

Treatment is individualized and depends on symptom severity and fertility goals. Options include:

Medical Management:

NSAIDs for pain relief

Hormonal therapies to suppress ovulation and menstruation:

Oral contraceptives

Progestins

GnRH agonists and antagonists

Surgical Treatment:

Laparoscopic excision or ablation of lesions

Hysterectomy in severe, refractory cases (often with oophorectomy)

Fertility treatment:

Assisted reproductive technologies (e.g., IVF) for women with infertility

Endometriosis is a chronic condition with a high recurrence rate. Early diagnosis and comprehensive management can improve quality of life and preserve fertility. Multidisciplinary care is often beneficial.

Endometriosis is a significant gynecological condition with diverse symptoms and considerable impact on women’s lives. Advances in diagnosis and treatment have improved outcomes, but awareness and timely intervention remain critical.