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Endometriosis affects almost 1/6 of women worldwide, often going unnoticed or being diagnosed late. In honor of March, which has been established as Endometriosis Awareness Month, let’s examine what exactly this disease is, how it affects women’s daily lives, and what are the latest developments in its diagnosis and treatment. 

What is endometriosis?

Endometriosis is a condition where the tissue that normally lines the inside of the uterus (endometrium) grows in other parts of the body, such as the ovaries, fallopian tubes, or other pelvic organs. This displaced tissue responds to the hormonal changes of the menstrual cycle, causing inflammation and pain. 

Although it is mainly observed in women of reproductive age, it can be diagnosed in young girls, who have just started menstruating or even after menopause. 

What are the symptoms of endometriosis?

1.Severe pain during menstruation (dysmenorrhea): Many women with endometriosis report pain before and during their period, which may extend to the lower back or pelvis. 

2. Chronic pelvic pain: Pain may more rarely occur throughout the cycle, not just on the days of your period.

3. Pain during sexual intercourse: Endometriosis often leads to discomfort or pain during or after sex, negatively affecting your sex life.

4. Difficulty conceiving: The disease is associated with infertility, due to inflammation or damage to organs such as the ovaries and fallopian tubes, as well as an immune reaction of unknown mechanism.  

5. Bowel or bladder disorders: In rare cases, there may be symptoms, such as bleeding during bowel movements or urination, especially during menstruation. 

How is endometriosis diagnosed?

A physical examination and a detailed history are the first steps. A transvaginal ultrasound is usually recommended to check for cysts or other suspicious signs of endometriosis. However, endometriosis foci in the peritoneum or other organs do not appear on ultrasound or even MRI, as they may be very small or non-visible. 

In reality, thedefinitive diagnosis of endometriosis is histological, i.e. precise confirmation is made by laparoscopy. This is a minimally invasive surgical method, where the doctor directly examines the internal organs with a special camera and takes tissue samples for examination. 

Why do many women ignore their symptoms?

Mainly due to the lack of information about the disease, both on the part of patients and on the part of doctors, an average of 10.4 years elapses between the appearance of symptoms and diagnosis. During this time, patients experience at least one misdiagnosis. As the symptoms can be quite general, misdiagnoses, such as irritable bowel syndrome or pelvic inflammatory disease, are common. In addition, many women consider severe period pain to be “normal” and do not seek medical help, while endometriosis. It may have mild or no symptoms, resulting in it going unnoticed for years. Early and correct diagnosis helps to treat symptoms and improve quality of life. 

What treatment options are there?

The treatment depends on the clinical picture, the woman’s age and her desire to have children. Some basic approaches include: 

• Drug treatment: Hormonal preparations (e.g., certain classes of contraceptives) are usually administered in a continuous cycle to reduce endometrial growth and pain. However, aggressive pharmaceutical treatment with injections that “put” women into early menopause is not recommended, as it causes significant side effects for the body and the psychology of the patient. 
• Surgical treatment: Laparoscopy makes it possible to remove and/or destroy the foci of endometriosis. In advanced or deep stages of endometriosis, Robotic Surgery can offer significant advantages for the patient, thanks to high precision and better tissue manipulation, offering less blood loss and faster recovery. As in advanced forms of endometriosis cases, infiltration of the pelvic nerves, intestine, diaphragm, ureter and bladder is observed, the treating physician must be prepared to deal with such situations using highly specialized laparoscopic or robotic techniques (such as those applied in Gynecological Oncology).  

Access to specialized gynecologists is critical, as it can contribute substantially to the radical cleansing of the disease and the proper management of the postoperative strategy to avoid recurrence. Possible incomplete cleansing of the disease in a first surgery can significantly complicate the possibility of a second additional surgery due to adhesions, while increasing the likelihood of complications. 

The decision for surgical or exclusively pharmaceutical treatment is made in collaboration with the doctor, taking into account the severity of the symptoms, the desire to have children and the age of the patient. At the same time, supportive treatments, such as physical therapy, dietary changes (avoiding sugar) and psychological support, can contribute to the overall improvement of everyday life. 

March and Endometriosis

March has been established internationally as Endometriosis Awareness Month. The aim is to inform women, their families and the general public about the symptoms, consequences and available treatments of the condition. Through speeches, seminars and campaigns, the “opening” of the discussion about a problem that often remains hidden is encouraged. 

How can we contribute to raising awareness?

• Share information: Get informed from reliable sources and promote knowledge to friends and family eq.

• Support the actions: Participate in information events and online campaigns. 

• Encourage the conversation: If you are experiencing symptoms or know someone who is, encourage them to seek medical advice. 

Endometriosis is not just “severe period pain,” but a chronic condition that can seriously affect women’s health and fertility. Early diagnosis, histological confirmation through laparoscopy, personalized treatment and proper information are the main “keys” for its effective treatment. March reminds us that only through open discussion and support can we encourage more women to seek the care and treatment they need, substantially improving their quality of life.