Endometriosis: what it is and how it is treated

What is endometriosis?

When we talk about endometriosis, we are referring to the presence of endometrial tissue—the inner lining of the uterus—in other areas of the body. This tissue responds to hormones in the same way it would inside the uterus, which can lead to different symptoms and changes throughout the body.

From a broader perspective, understanding what endometriosis is means recognizing that it is not just a gynecological condition. It is considered an inflammatory disease that can affect the immune system, the microbiota, and hormonal balance, particularly in the regulation of estrogen.

Symptoms of endometriosis

Pain

The most characteristic symptom of endometriosis is pain. It may appear, for example, as:

1. pain during menstruation
2. pain before menstruation
3. lower back pain

Pain may also occur in areas where endometriotic tissue is present outside the uterus, such as:

1. in the lower back (causing lower back pain)
2. in the pelvic area (causing pelvic pain)
3. in the kidney (causing kidney pain)
4. in a scar (in this case, it will cause pain when the scar tissue becomes inflamed)

Premenstrual syndrome

Many patients experience severe premenstrual syndrome, with emotional changes, irritability, or bleeding before menstruation. In some cases, periods can be debilitating, making it necessary to take anti-inflammatory medication in order to carry out daily activities. Some women may even experience dizziness, nausea, or vomiting.

Fatigue or tiredness

The inflammation associated with the disease can cause persistent fatigue, a lack of energy, and digestive problems related to the microbiota.

Recurrent infections

Some women with endometriosis experience recurrent infections, such as urinary tract infections or candidiasis. These episodes are often not initially linked to the disease, although they may be part of the same inflammatory process affecting the body.

Causes of endometriosis

Endometriosis is characterized by a significant inflammatory component. Therefore, to better understand the disease, it is necessary to analyze the origin of this inflammation.

In some cases, there may be associated issues in different areas of the body, such as:

1. digestive disorders
2. the presence of infections such as Helicobacter pylori
3. intestinal inflammation or irregularities in digestive transit
4. it has also been observed that some patients have reactivated viruses or alterations in the microbiota

Another relevant factor is hormonal balance. Many patients have increased estrogen activity and relatively low progesterone levels. This situation may be influenced by genetic factors and by increased activity of the aromatase enzyme, which promotes estrogen production.
This excess estrogen can create a vicious cycle: the inflammation increases hormonal activity, which in turn causes even more inflammation. In addition, differences have been identified in the microbiota of the reproductive tract and in the immune system response of women with endometriosis.

How is endometriosis treated?

One of the most common questions asked during consultations is, naturally, how endometriosis is treated. Endometriosis does not have a cure as such; our goal is to improve the patient’s symptoms by addressing the disease at its source.
This 360º approach involves identifying what is happening in each individual case and designing a personalized treatment plan with different objectives:

1. reduce inflammation
2. improve estrogen regulation
3. reduce exposure to endocrine disruptors
4. promote better hormonal balance by increasing progesterone levels when necessary

It may also be important to modulate the immune system and improve the microbiota. In addition, treatment may include addressing other aspects that affect the patient’s quality of life, such as sexual health, chronic pelvic pain, or psychological well-being.
Conventional treatments focus on the use of hormonal contraceptives to control symptoms. Although they may help some patients, this approach often acts as a temporary solution, as it does not always address the root cause of the problem.
For this reason, there is a growing emphasis on a comprehensive approach to endometriosis that takes into account all the factors involved in the disease and helps improve both symptoms and the patient’s overall well-being.

International Endometriosis Day

On International Endometriosis Day, the Integrative Gynecology Unit highlights the importance of prevention and taking care of health from an early age. Listening to your body, recognizing warning signs, and consulting trusted healthcare professionals are key to detecting and addressing conditions such as endometriosis at an early stage.

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