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Endometriosis

A chronic estrogen-dependent disorder in which endometrium-like tissue grows outside the uterus, causing pain and fertility problems.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

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What is Endometriosis?

Endometriosis is defined by the presence of endometrium-like tissue outside the uterine cavity, most commonly on the pelvic peritoneum, ovaries (endometrioma), uterosacral ligaments, and bowel or bladder.

Proposed mechanisms include retrograde menstruation, coelomic metaplasia, and immune dysregulation; estrogen-driven inflammation produces adhesions, nodules, and neural changes.

It is classified as superficial peritoneal disease, ovarian endometrioma, and deep infiltrating endometriosis, with laparoscopy traditionally required for definitive staging.

Management follows ESHRE guidance and aims to relieve pain, preserve fertility, and prevent recurrence with hormonal and surgical strategies.

Symptoms

Chronic or cyclic pelvic pain beginning before or during menstruation
Severe dysmenorrhea requiring analgesics or limiting daily activities
Deep dyspareunia, especially on deep penetration
Dyschezia, dysuria, or cyclic bowel and bladder symptoms
Subfertility or difficulty conceiving
Fatigue, bloating, and cyclic shoulder pain in thoracic endometriosis

Risk Factors

Family history of endometriosis in first-degree relatives
Early menarche and short menstrual cycles with heavy flow
Nulliparity and delayed childbearing
Müllerian anomalies and outflow obstruction
Low body mass index
Exposure to endocrine-disrupting chemicals

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Painful periods that interfere with work, school, or daily activities
  • Painful intercourse, cyclic bowel or bladder symptoms, or persistent pelvic pain
  • Difficulty conceiving after 6–12 months, particularly with symptoms suggestive of endometriosis

Treatment Methods

01
Clinical diagnosis supported by transvaginal ultrasound and pelvic MRI for deep infiltrating disease
02
First-line medical therapy: combined hormonal contraceptives or progestogens and non-steroidal anti-inflammatory drugs
03
Levonorgestrel-releasing intrauterine system and oral progestogens such as dienogest
04
GnRH analogues with add-back therapy or GnRH antagonists for selected refractory cases
05
Laparoscopic excision or ablation of lesions, ovarian endometrioma cystectomy, and adhesiolysis with fertility preservation
06
Multidisciplinary care including fertility specialists, pelvic floor physiotherapy, pain psychology, and lifestyle support

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.