Endometriosis

Endometriosis — is a chronic gynecological condition in which tissue similar in structure to the endometrium (the uterine lining) grows outside the uterine cavity. Lesions can localize on the ovaries, peritoneum, intestines, bladder, and other structures of the pelvis. The disease is accompanied by inflammation, pain syndrome, and can affect fertility.

What happens in endometriosis

Ectopic lesions respond to hormonal fluctuations of the menstrual cycle similarly to the endometrium inside the uterus. This leads to cyclical inflammation, tissue swelling, and the formation of adhesions. Over time, the formation of cysts (endometriomas) and chronic pelvic pain may occur.

The exact cause of the disease has not been definitively established. Hormonal, immune, genetic, and inflammatory mechanisms are being considered.

Main symptoms:

• painful menstruation;
• chronic pelvic pain;
• pain during intercourse;
• bowel or urinary disturbances when neighboring organs are involved;
• difficulties with conception.

The severity of symptoms does not always correlate with the extent of the lesions.

Diagnosis and treatment

Diagnosis is based on the clinical picture, ultrasound data, MRI, and, if necessary, laparoscopy. The latter remains the most accurate method for confirming the diagnosis.

Treatment. The strategy depends on age, severity of symptoms, and reproductive plans:

• hormonal therapy to suppress the activity of lesions;
• non-steroidal anti-inflammatory drugs to control pain;
• surgical removal of lesions in cases of significant symptoms;
• combined approach in case of recurrences.

Nutrition and lifestyle

Endometriosis is associated with chronic inflammation and hormonal sensitivity of tissues. Diet can influence the severity of symptoms through metabolic mechanisms:

• weight control;
• reduction of sugar and ultra-processed food intake;
• adequate intake of omega-3 fatty acids;
• maintenance of vitamin D levels;
• regular physical activity.

Low-carbohydrate or ketogenic diets may reduce systemic inflammation and stabilize insulin levels, but they are considered an adjunct strategy and require individual assessment.

Prognosis

Endometriosis — is a chronic condition with the possibility of recurrences. Early detection and a comprehensive approach can reduce pain severity and improve quality of life.

Therapy selection is carried out individually, taking into account the clinical picture and reproductive plans.