Endometriosis is a chronic gynecological disease that affects millions of women of reproductive age. Despite being relatively common, many patients live for years with symptoms before receiving the correct diagnosis. This happens because intense cramps and pain during menstruation are still frequently considered "normal," when, in fact, they may indicate a condition that deserves medical investigation.
In this article, you will understand what endometriosis is, what its symptoms are, risk factors, how diagnosis is made, what treatment options are available, and when to see a doctor.
What is endometriosis?
Endometriosis is a chronic inflammatory disease characterized by the growth of tissue similar to the endometrium—the layer that lines the inside of the uterus—in locations outside the uterine cavity.
This tissue may develop on the ovaries, fallopian tubes, bladder, intestine, uterine ligaments, peritoneum, and, in rarer cases, in other parts of the body.
Like normal endometrium, this tissue responds to hormonal changes in the menstrual cycle. Each month it can become inflamed, bleed, and cause pain, scarring, and adhesions.
Endometriosis is not an infection, is not contagious, and is not cancer.
What are the symptoms of endometriosis?
Symptoms vary from woman to woman. Some experience few symptoms, while others live with intense pain that significantly compromises their quality of life.
The main symptoms include:
- Intense menstrual cramps.
- Chronic pelvic pain.
- Pain during sexual intercourse.
- Pain during bowel movements during menstruation.
- Pain when urinating during menstruation.
- Intestinal changes during the menstrual period.
- Urinary or intestinal bleeding during menstruation, in some cases.
- Difficulty becoming pregnant.
- Abdominal bloating.
- Lower back pain.
- Frequent fatigue.
Not every menstrual cramp means endometriosis, but intense, debilitating pain, or pain that worsens over the years should be evaluated by a doctor.
What are the classic signs of endometriosis?
Although symptoms may vary, some signs are considered quite suggestive of the disease:
Intense menstrual cramps
Cramps tend to become progressively stronger over the years and can prevent daily activities, work, or studies.
Pain during sexual intercourse
Pain usually occurs during deep penetration and may persist even after intercourse ends.
Pelvic pain
Some women experience pain nearly every day, even outside the menstrual period.
Intestinal changes
May include:
- Constipation.
- Diarrhea.
- Pain during bowel movements.
- Sensation of incomplete evacuation.
These symptoms tend to worsen during menstruation.
Urinary changes
When the disease affects the bladder, pain when urinating, increased urinary frequency, and in some cases, blood in the urine during the menstrual period may occur.
Infertility
In some women, difficulty becoming pregnant is the first sign of the disease.
What are the causes of endometriosis?
The exact cause of endometriosis is still not fully known.
Studies suggest that the disease results from a combination of various factors, such as:
- Genetic predisposition.
- Retrograde menstruation.
- Hormonal alterations.
- Alterations in the immune system.
- Environmental factors.
There is still no proven way to prevent the development of the disease.
Who is at higher risk of developing endometriosis?
Some factors increase the risk, including:
- Family history of endometriosis.
- Early first menstruation.
- Short menstrual cycles.
- Prolonged menstruation.
- Never having been pregnant.
- Hormonal alterations.
Having risk factors does not mean a woman will necessarily develop the disease.
Where can endometriosis occur?
The most frequently affected sites are:
- Ovaries.
- Fallopian tubes.
- Uterine ligaments.
- Peritoneum.
- Intestine.
- Bladder.
- Ureters.
In less common cases, it may also affect the diaphragm, lungs, and other regions of the body.
How is endometriosis diagnosed?
Diagnosis begins with a detailed clinical evaluation.
During the consultation, the doctor investigates:
- Characteristics of pain.
- Menstrual cycle.
- Family history.
- Intestinal symptoms.
- Urinary symptoms.
- Desire to become pregnant.
When necessary, tests may be ordered such as:
- Transvaginal ultrasound with bowel preparation.
- Pelvic magnetic resonance imaging.
In some cases, definitive diagnosis occurs during surgery.
The earlier the disease is identified, the greater the chances of controlling symptoms and preventing complications.
What are the risks of endometriosis?
Without appropriate treatment, the disease may progress and cause:
- Chronic pain.
- Formation of adhesions.
- Intestinal involvement.
- Urinary involvement.
- Ureteral obstruction.
- Reduced fertility.
- Infertility in some cases.
In addition to physical complications, endometriosis can also impact emotional well-being, professional life, relationships, and quality of life.
How can endometriosis affect daily life?
The disease can interfere with different aspects of life.
Professional life
Intense pain can cause absences from work, reduced productivity, and difficulty performing daily activities.
Social life
Many women stop participating in commitments due to pain crises.
Sexual life
Pain during intercourse can affect intimacy and generate insecurity.
Fertility
Not every woman with endometriosis will be infertile, but the disease can make pregnancy difficult in some cases.
Emotional health
Living with chronic pain can increase the risk of anxiety, stress, and depressive symptoms.
How is endometriosis treated?
Treatment depends on the patient's age, intensity of symptoms, disease location, extent of lesions, and desire to become pregnant.
The main options include:
- Medications to control pain.
- Hormonal treatment.
- Surgery to remove endometriosis lesions, when indicated.
- Lifestyle changes, such as regular physical activity, balanced nutrition, stress management, and multidisciplinary follow-up.
Each patient should be evaluated individually to define the best therapeutic strategy.
Is there a cure for endometriosis?
Endometriosis is considered a chronic disease.
Although there is currently no definitive cure for all cases, treatment can control symptoms, reduce disease progression, preserve fertility when possible, and provide excellent quality of life.
When to see a doctor?
It is recommended to seek medical care if you experience:
- Very intense menstrual cramps.
- Pain that prevents daily activities.
- Pain during sexual intercourse.
- Pain during bowel movements or urination during menstruation.
- Intestinal changes related to the menstrual cycle.
- Difficulty becoming pregnant.
- Frequent pelvic pain.
The earlier the diagnosis, the greater the chances of preventing complications and improving quality of life.
Frequently asked questions about endometriosis
Is every severe cramp endometriosis?
No. There are various causes for intense cramps. Only a medical evaluation can identify the source of the pain.
Does everyone with endometriosis become infertile?
No. Many women with endometriosis become pregnant naturally. However, the disease can reduce fertility in some cases.
Does pregnancy cure endometriosis?
No. During pregnancy, symptoms may improve due to hormonal changes, but this does not mean the disease has been cured.
Can endometriosis return after treatment?
Yes. Even after surgery or medication treatment, the disease can reappear, making medical follow-up important.
Can endometriosis turn into cancer?
In the vast majority of cases, no. Malignant transformation is rare.
Conclusion
Endometriosis is a frequent disease that can significantly compromise quality of life when not properly diagnosed and treated. Debilitating menstrual cramps, pain during sexual intercourse, intestinal or urinary changes related to the menstrual cycle, and difficulty becoming pregnant should not be ignored.
Early diagnosis and individualized treatment are fundamental to control symptoms, reduce complications, and preserve women's health. If you show signs suggestive of endometriosis, seek medical evaluation to receive appropriate guidance and follow-up.
This content is exclusively informative and educational and does not replace evaluation, diagnosis, treatment, or consultation with a qualified healthcare professional.
Dr. Rebeca Soares Andrade CRM - GO 39335