Endometriosis
What is endometriosis? What are the symptoms and how can they be alleviated? Explore our health section to better understand this condition.
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I. Definition and Key Facts
Endometriosis is a chronic gynecological condition characterized by the abnormal presence of tissue similar to the endometrium (the lining of the uterus) outside the uterine cavity [1]. These tissues can develop in the ovaries, fallopian tubes, bladder, uterine ligaments, the walls of the rectum and vagina, the peritoneum, or more broadly within the pelvic region, although it is rare for them to spread to other parts of the body [2].
Under the influence of menstrual cycle hormones, these tissues thicken and bleed without being able to evacuate naturally. This leads to inflammation, severe pain, and sometimes scars. Endometriosis can progress from puberty to menopause and may impair fertility [2,5].
- Endometriosis affects around 10% of women of reproductive age worldwide [1].
- Women between 25 and 49 years old are the most affected [2].
- An estimated 40% of women with chronic pelvic pain may have undiagnosed endometriosis [3].
- Endometriosis is involved in 40% of female infertility cases [3].
II. Causes
The exact causes of endometriosis are not yet clearly understood. Several hypotheses are being explored to explain its onset and progression [1].
- Retrograde menstruation: During menstruation, some menstrual blood may flow backward into the pelvic cavity instead of exiting the body. This blood contains cells from the uterine lining. Once displaced, these cells can attach to other organs in the lower abdomen and continue to grow, even though they should normally be eliminated [2].
- Cell transformation: Some cells located outside the uterus may transform into endometrial-like cells, leading to endometriotic lesions [5].
- Genetic or immune factors: Some individuals may have a predisposition to endometriosis, especially when family members are affected [4].
- Individual factors: The risk of endometriosis is higher in women with a low Body Mass Index (BMI), heavy menstrual bleeding, or short menstrual cycles [4].
- Hormonal influence: Endometriosis is a hormone-dependent condition, particularly linked to the action of estrogen and progesterone, which trigger bleeding of the lesions during menstruation, causing inflammation [5].
- Endocrine disruptors: Certain chemicals containing endocrine-disrupting substances are suspected of interfering with hormonal balance and may contribute to the development of endometriosis [6].
III. Symptoms
Symptoms of endometriosis vary widely from one woman to another. The condition may be silent or, conversely, highly debilitating [1]. The most common symptoms include:
- Painful periods: Severe menstrual cramps (dysmenorrhea) are the most frequent symptom. The pain can be intense and interfere with daily activities [2].
- Chronic pelvic pain: Some women experience persistent pain in the lower abdomen or pelvis, even outside their menstrual periods [2].
- Pain during or after sexual intercourse (dyspareunia): This symptom is common among women with endometriosis [2].
- Digestive issues: Depending on the location of the lesions, endometriosis may cause diarrhea, bleeding, constipation, or pain during bowel movements [5].
- Urinary symptoms: If the bladder or urinary tract is affected, women may experience pubic bone pain, discomfort when urinating, or blood in the urine [5].
- Severe fatigue: Chronic pain and inflammation can lead to significant physical and psychological fatigue [1].
- Difficulty conceiving: Around 30–40% of women with endometriosis experience fertility problems [2].
IV. Prevention
There is currently no guaranteed method to completely prevent endometriosis. However, certain measures may help reduce risks or support earlier diagnosis.
- Monitoring pain: Consulting a healthcare professional promptly in case of unusually intense menstrual pain can help reduce diagnostic delays [2].
- Knowing the risk factors: Heavy periods, short menstrual cycles, or a family history of endometriosis are associated with higher risk. Being aware of these factors encourages vigilance and timely consultation [4].
- Limiting exposure to endocrine disruptors: These chemical substances, present in some everyday products, are suspected of affecting hormonal balance, including conditions such as endometriosis. Reducing exposure when possible is a precautionary measure [6].
- Regular medical follow-up: Routine gynecological examinations help detect abnormalities earlier and support appropriate management [3].
V. Treatments
There is currently no cure for endometriosis. Treatment focuses on relieving pain, improving quality of life, and preserving fertility [1].
- Pain medication: Analgesics or anti-inflammatory drugs may be prescribed to reduce pain and slow the growth of endometrial-like tissue developing outside the uterus, whether during menstruation or daily life [5].
- Hormonal treatments: Contraceptive pills, hormonal intrauterine devices, or other medications can block or reduce menstrual cycles, limiting the progression of lesions [2].
- Surgery: Surgical treatment may be used to remove or destroy misplaced tissue and lesions. It is recommended when pain persists despite treatment or in case of complications [1].
- Holistic approach: Combined with regular medical follow-up, psychological support, personalized nutritional advice, and adapted physical activity can help improve patients’ daily well-being [7].
POI 1118-01/26
Sources:
[1] https://www.who.int/fr/news-room/fact-sheets/detail/endometriosis
[2] https://www.inserm.fr/dossier/endometriose/
[3] https://www.pasteur.fr/fr/centre-medical/fiches-maladies/endometriose
[4] https://www.ameli.fr/yvelines/assure/sante/themes/endometriose/definition-facteurs-favorisants
[7] Quels traitements pour l’endométriose ? • Fondation pour la Recherche sur l’Endométriose