Better understanding, better awareness, better treatment of endometriosis: On the occasion of World Endometriosis Day, we discussed the matter with Dr. Zaki Sleiman, gynecologist and obstetrician at LAU Medical Center-Rizk Hospital.

Endometriosis is a chronic gynecological disease that affects 1 in 10 women. It is characterized by the presence of uterine mucosa (endometrium) outside the uterus, which, unlike normal, attaches and develops on adjacent organs such as the fallopian tubes, bladder, and ovaries.

Indeed, endometriosis is distinguished into several types according to the stage of development: ovarian endometriosis, characterized by the presence of cysts on the ovary, and deep endometriosis, defined by the presence of lesions more than 5 mm from the surface of the peritoneum. The most affected organs are the ovaries, vagina, or uterosacral ligaments.

Furthermore, the symptoms induced by endometriosis are most often pain and infertility. Their severity is not related to the extent of the lesions induced by this disease.

Thus, the major symptom is acute recurrent pelvic pain, especially at the time of menstruation. This characteristic is indicative of the disease. Outside the period of menstruation, patients may also suffer during sexual intercourse or when they urinate or defecate.

Consequently, the disease can be asymptomatic. In this case, it is generally discovered unexpectedly when the patient consults due to difficulty in becoming pregnant. A significant proportion of endometriosis patients are infertile. A clinical and ultrasound examination, or even MRI, can detect endometriosis.

Moreover, when a patient discovers her endometriosis due to pain, she is often initially offered hormonal treatment (oral contraceptives). This treatment reduces pain and may help stabilize endometriosis lesions, slightly reducing their volume. However, it does not allow their complete elimination. Surgery is the only treatment that allows the elimination of lesions associated with endometriosis. It is performed in cases of disabling symptoms and/or infertility. Furthermore, for women who wish to have a baby, IVF (in vitro fertilization) is often necessary.