Endometriosis is a chronic disease that affects 10% of women of reproductive age, with a prevalence similar to diabetes. However, it is little known both by society and by many health professionals, which causes late diagnoses, ineffective treatments and, sometimes, years of unnecessary discomfort. Although it is a leading cause of pelvic pain and reproductive problems, its impact remains underestimated and its understanding is limited.
Causes and symptoms of the disease
Endometriosis is characterized by the presence of endometrial tissue outside the uterus that reacts to the hormones of the menstrual cycle, causing inflammation, scarring and, often, adhesions between organs. These lesions can be located in the ovaries, fallopian tubes, intestines and even in more distant areas, such as the diaphragm or lungs. The most common symptom is severe menstrual pain, although it can also present as chronic pelvic pain, discomfort during sexual intercourse or defecation, and infertility. In the case of Dolors, a patient at Hospital Clínic Barcelona, the pain and adhesions affected her uterus and ovaries, incapacitating her until she underwent surgery.
Menstrual pain has always been considered normal, both by women, who do not consult, and by professionals who see it as something common.
Of concern is not only the debilitating nature of the disease, but also the long time it usually takes to diagnose it. Studies indicate that patients with endometriosis can wait between 7 and 10 years to receive an accurate diagnosis, which perpetuates their pain and allows the disease to progress. During this period, endometrial tissue can continue to invade organs, causing complications and increasing the need for surgical interventions.
Part of the problem lies in the lack of training and awareness, both in society and in the medical field. Meritxell Gràcia, gynecologist at Hospital Clínic Barcelona, points out that menstrual pain has historically been normalized: “It has always been considered normal, both by women, who do not consult, and by professionals who see it as something common.” This approach has contributed to the stigma surrounding endometriosis. Many patients, like Alba, recount years of neglect and comments that reduce their pain, such as “it’s part of being a woman” or “periods hurt.” This delays diagnosis and condemns many women to years of suffering.
I was in bed all day, I couldn’t move. I couldn’t work, or even have social relationships. Now I can see my parents again and work, but this shouldn’t have happened to me.
Treatments to relieve pain
Since there is no cure for endometriosis, current treatments focus on managing symptoms. The most common is the use of hormonal contraceptives to stop ovulation and, therefore, the menstrual cycle. Although they may be effective for some patients, they do not always work and often have significant side effects. Furthermore, the suppression of menstruation can affect the mental and emotional health of patients, generating a constant state of “pseudo-menopause.”
It is a disease that affects too many women.
In the most serious cases, when medical treatments are insufficient, surgery is resorted to. Dolors, who suffered from adhesions affecting her reproductive organs, found relief after surgery to remove the lesions. However, surgery is not a definitive solution: endometriosis can reappear, forcing many patients to undergo several operations throughout their lives, with the consequent risk of new adhesions or complications in other organs.
The impact of endometriosis on fertility is also of concern. It is estimated that between 30% and 40% of affected women have difficulty conceiving. This, added to chronic pain, can have a devastating psychological effect. Eva Flo, a patient at Hospital Clínic Barcelona, recounts how the disease affected her mental health, leading her to a state of severe depression: “I was in bed all day, I couldn’t move. I couldn’t work, or even have social relationships. Now I can see my parents again and work, but this should not have happened to me.”
Endometriosis, as Dr. Gràcia points out, is “a disease that affects too many women” and should not be taken lightly. Experts stress that although mild menstrual pain is common, disabling pain requires a thorough evaluation. The delay in diagnosis, which in some cases can last for years, reflects the tendency to underestimate women’s health and the urgency of investing resources in health research and training. The message is clear: pain is not normal and menstruation should not be the cause of extreme pain.
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