What is Endometriosis?

Endometriosis is a chronic gynecological condition characterized by the growth of endometrial tissue — which normally lines the inside of the uterus — in other areas outside the uterus.

Most commonly, endometriosis is found in the peritoneal region, on the ovaries, urinary bladder, intestines, and the rectovaginal septum. In rarer cases, endometrial tissue has been reported on the diaphragm, internal organs, lungs, and even the brain.

It is estimated that 1 in 10 women of reproductive age is affected by endometriosis, and up to 50% of women with infertility are suspected to have this condition.

However, there have also been reported cases of girls without menarche (first menstruation) diagnosed with endometriosis. Additionally, cases have been recorded where the condition appeared after a hysterectomy (surgical removal of the uterus). Several theories have been proposed regarding the pathogenesis of endometriosis, but none has so far succeeded in encompassing all the characteristics and variations of this disease. These atypical cases demonstrate that we are dealing with a multifactorial condition with a variable and often unpredictable response to currently available therapeutic strategies.

How Does Endometriosis Manifest?

Endometriosis can present in various forms:

• Adhesions: These appear as bands of fibrous tissue that connect organs to each other, causing pain, disrupting intestinal transit (constipation or even bowel obstruction), and may require further surgical intervention.
• Endometriomas: Typically present as cystic structures with low internal echogenicity, but they can also have dense septa, thickened walls, or echogenic foci.
• Nodules: Variable-sized formations that can develop in various pelvic areas. Endometriotic nodules may be located between the vagina and rectum, in the bladder, colon, vagina, or even the lungs.

The two main manifestations of this chronic disease are chronic pelvic pain of varying intensity and infertility. More than 70% of patients diagnosed with endometriosis experience one or more recurrences during their lifetime. This aspect affects the physical and psychological well-being of patients with endometriosis. All these symptoms have a negative impact on quality of life.

What is Endometriosis?

Another form of endometriosis is adenomyosis. This condition occurs exclusively in the uterus, located within the myometrium (the muscular layer of the uterus). It can be identified as focal adenomyosis (clusters of endometrial tissue) or diffuse adenomyosis (dispersed lesions present in various areas of the myometrium).