Endometriosis

What it is

Endometriosis is a chronic inflammatory condition that can cause intense cramping, pelvic pain, pain during intercourse, menstrual-related bowel and urinary changes, and difficulty becoming pregnant. For many women, clinical treatment is the first choice: it combines hormonal medications that reduce or suspend menstruation, pain relief, dietary care, physical activity and, when needed, support from other professionals, such as a pelvic physical therapist and a psychologist. The goal is to relieve pain, control the disease, and preserve quality of life and fertility. When clinical treatment is not enough, surgery may be considered.

Most common symptoms

• Intense menstrual cramps that worsen over time
• Pelvic pain outside the menstrual period
• Pain during intercourse
• Pain with bowel movements or urination during menstruation
• Abdominal bloating and bowel changes during the period
• Difficulty becoming pregnant
• Fatigue and irregular menstrual bleeding

Causes and risk factors

• Retrograde menstruation, with reflux of endometrial tissue into the pelvis
• Genetic predisposition and family history
• Hormonal and immune factors
• Early first period and short cycles with heavy flow
• Never having been pregnant and prolonged estrogen exposure

How it is diagnosed

The consultation begins with careful attention to the symptoms: the intensity and progression of cramping, pain during intercourse, bowel and urinary symptoms during the menstrual period, and difficulty becoming pregnant. The gynecological exam can identify tender points and nodules. Transvaginal ultrasound with bowel preparation, performed by a specialized professional, maps the lesions; MRI complements the workup in selected cases. Blood tests can help, but do not confirm the disease on their own. Laparoscopy is reserved for specific situations, when the diagnosis is uncertain or surgery is indicated.

How we treat it at Femi Saúde

For many women, clinical treatment is the first choice. The Femi Saúde gynecology team combines hormonal medications that reduce or suspend menstruation, such as continuous-use contraceptives, progestins and the hormonal IUD, with guided pain relief, an anti-inflammatory diet and regular physical activity. Pelvic physical therapy helps control the pain, and multidisciplinary follow-up, with a psychologist and nutritionist, supports quality of life. Those who wish to become pregnant receive guidance on the right timing and on assisted reproduction, when needed. If pain persists or there are lesions that justify intervention, laparoscopic surgery may be considered. The plan is individualized and reviewed throughout follow-up.

What we offer