Endometriosis: a common but not always timely diagnosed problem

Endometriosis is one of the most common gynecological diseases, but it often goes unnoticed or is mistakenly attributed to other health problems. This disease develops when tissue similar to the lining of the uterus begins to grow outside the uterine cavity—in the walls of the uterus, ovaries, fallopian tubes, peritoneum covering the bladder, or intestines.

Although millions of women worldwide suffer from endometriosis, the symptoms vary greatly and are not always clearly recognizable, so women suffer from pain and other ailments for a long time before finally getting an accurate explanation of what is causing them.

What are the symptoms of endometriosis? How is this disease treated? We discuss this with obstetrician-gynecologist Dr. Ingrida Jackūnienė.

Common symptoms

The most common symptom of endometriosis is severe and painful abdominal and/or pelvic pain during menstruation. However, many women consider pain during menstruation to be "normal" for a long time and only consult a specialist when the pain becomes unbearable or begins to interfere with their daily lives.

"We may suspect endometriosis when a patient complains of very painful menstruation that has continued since adolescence. Although the pain is so severe that it can even cause nausea, patients usually take painkillers and suffer, thinking that this is normal and that all women experience it," the doctor shares her experience. " – the doctor shares her experience.

However, pain is not the only symptom. Women may also experience:

• Pain during sexual intercourse;

• Heavy menstrual periods;

• Brown discharge before and after menstruation;

• Chronic fatigue, weakness, hair loss;

• Digestive disorders, bloating;

• Difficulty conceiving.

Diagnosing endometriosis is complicated primarily due to the variety of symptoms, which can be misleading not only for patients but also for doctors. Since many of these symptoms overlap with other gynecological or digestive diseases, endometriosis is often confused with irritable bowel syndrome or even urinary tract infections.

"Over time, the symptoms intensify. Pain becomes a more frequent companion for women – it hurts before and during menstruation, and sexual intercourse can be painful. The pain is felt in the lower abdomen, lower back, and may also hurt in the side or pelvis. If the disease has affected the peritoneum covering the bladder or the intestinal wall, it can cause chronic recurrent painful urination or very painful bowel movements, especially during menstruation. At the same time, the abdomen becomes bloated and constipation occurs. It is not surprising that patients often consult other specialists first and only later turn to gynecologists," says Dr. I. Jackūnienė, speaking about the misleading symptoms.

In addition, the disease is not always detectable in the early stages using standard tests. One of the main methods used to assess the condition of the pelvic organs is ultrasound, which can reveal cysts or other changes in the uterine walls and ovaries that are characteristic of endometriosis.

Obstetrician-Gynaecologist, Ingrida Jackūnienė

Possible consequences

Untreated endometriosis can cause serious complications, the most common of which are:

• Infertility or difficulty conceiving;

• Chronic abdominal and pelvic pain;

• The formation of cysts (endometriomas) in the ovaries, which may require surgical treatment;

• Adhesions, which can impair the functioning of internal organs.

These consequences are very distressing for women and cause long-term health problems, worsening a woman's quality of life, so it is important to diagnose and treat endometriosis as early as possible.

The treatment of endometriosis depends on the severity of the symptoms, the patient's age, and planned pregnancy. Non-steroidal anti-inflammatory drugs (NSAIDs) may be used for treatment, but the most appropriate and effective treatment is hormone therapy (contraceptive pills, hormonal intrauterine device, other hormonal drugs).

Medication with hormonal preparations slows down and reduces the growth of pathological tissues and their progression, and reduces the likelihood of surgical treatment. If the disease is diagnosed at an advanced stage, surgical treatment is used to remove cysts and pathological endometriosis implants, often together with the affected organ or part of it.

When this disease causes infertility, assisted reproduction procedures may be necessary, so it is essential that treatment is individualized and tailored to each woman's situation and current condition.

"We should be glad that over the last decade we have gained more knowledge about endometriosis, making it easier and faster to recognize the disease. Ultrasound examination capabilities and specialist competence are improving, and with a timely diagnosis, we can prescribe effective hormone treatment earlier and improve women's health," said the doctor, highlighting the positive trends and medical progress.

The doctor adds that endometriosis is a chronic inflammatory disease that subsides and becomes completely inactive only after a woman enters menopause, so it is important to remember to get regular check-ups. Women of childbearing age who suffer from endometriosis symptoms should visit a gynecologist 1-2 times a year, depending on their health condition.