Endometriosis affects up to one in ten women of reproductive age. What is known today is that it is a chronic inflammatory estrogen-dependent disease caused by the presence of endometrial tissue outside the uterus, including in the ovaries, uterine muscle, and rectovaginal space. However, its causes remain a mystery, diagnosis is challenging, and treatment remains symptomatic.
March is endometriosis awareness month, culminating in World Endometriosis Day on March 30. Researchers at the Institute of Animal Reproduction and Food Research of the Polish Academy of Sciences in Olsztyn are also studying the biology of endometriosis and adenomyosis, a disease similar to endometriosis.
Unanswered Questions About Endometriosis
– Although endometriosis is being diagnosed more frequently, we still know too little about the disease itself. For reasons still unknown to us, endometrial tissue—the lining of the uterus—migrates outside the uterine cavity. Most commonly, it affects the ovaries, peritoneum (the membrane lining the abdominal cavity and covering many organs), and the rectovaginal space, but it can also be found in the intestines, lungs, eyes, brain, and bladder. It has even been observed in scars from cesarean sections – explains Professor Sławomir Wołczyński, head of the Human Reproduction Biology and Pathology Team.
The most widely accepted theories suggest that endometriosis is caused by retrograde menstruation, in which menstrual blood flows backward through the fallopian tubes, allowing endometrial fragments to enter the abdominal cavity, implant themselves, and even spread through the lymphatic system.
With each menstrual cycle, the tissues forming endometriosis lesions also shed and bleed—though outside the uterus. This not only causes irritation and inflammation but also severe pain. Pain is the primary clinical symptom of endometriosis, along with heavy menstrual bleeding, painful urination with blood, painful bowel movements, and digestive issues.
A significant impact on women’s lives
– Although endometriosis is not usually a malignant disease, it significantly reduces women’s quality of life. Many patients experience unbearable menstrual pain without pharmacological suport – emphasizes dr Maria Sztachelska from the Human Reproduction Biology and Pathology Team.
The disease is also a major cause of infertility. – Epidemiological analyses and our clinical observations indicate that today, endometriosis is one of the leading causes of infertility – notes Profesor Sławomir Wołczyński.
Since the root cause of endometriosis is unknown, treatment is only symptomatic. The standard approach includes pharmacological treatment—pain relief and suppression of endometriosis lesion activity. – Surgical treatment can also be effective, but decisions about surgery must be made with particular caution in patients who have not yet completed their plans for motherhood – explains Professor Wołczyński.
Adenomyosis is a condition similar to endometriosis and also estrogen-dependent. In this case, endometrial tissue is located within the uterine muscle. The exact mechanism of this disease is also not yet fully understood.
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The full article was published on the portal Academia, issued by the Polish Academy of Sciences: Academia.
