Endometriosis

Endometriosis is a chronic inflammatory disease that not only affects general physical health but can also have a significant impact on individual mental well-being and relationships. It is estimated that approximately 10 to 15% of women are affected by this disease and that 30 to 40% of infertile women suffer from this condition to varying degrees. Symptoms tend to improve during the menopause.

In this disease, the lining of the uterine cavity (endometrium) implants itself outside the uterus (e.g. ovaries, peritoneum, fallopian tubes, vagina, bladder, intestines, diaphragm, abdominal scars, etc.). Each month, under the influence of hormones produced by the ovaries, these areas bleed and cause inflammation of the surrounding tissues, leading to the formation of nodules, fibrosis and adhesions. Over time, this disease, which begins superficially, gradually infiltrates the tissues and becomes increasingly difficult to eradicate completely.

Endometriosis is a chronic disease with cyclical painful manifestations whose symptoms depend on their location (dysmenorrhoea, pelvic pain, dyspareunia, dysuria, dyschezia, haematuria, fatigue, rectal bleeding, etc.) and the time of the cycle. The fertility of women with endometriosis can be affected to varying degrees.

Endometriosis is initially diagnosed through a detailed medical history combined with a clinical examination. Radiological examinations (endovaginal or transrectal ultrasound, pelvic MRI, abdominal CT scan) to look for nodules, cysts or other radiologically visible abnormalities may be performed depending on the case, but their sensitivity is limited.

The gold standard remains diagnosis by laparoscopy (biopsy). Saliva testing (currently not covered by LAMAL) may be performed in specific cases.

The goals of treatment are to reduce pain and improve fertility through three main approaches: painkillers, hormones and surgery.

Managing pain syndrome is complex and often involves multiple approaches. The treatments offered depend on the symptoms, age, desire to become pregnant, type and location of the endometriosis, and the patient's preferences. It is important to note that endometriosis symptoms can recur despite medical and surgical treatment.

If surgery is necessary, it can be performed at Sion Hospital using a minimally invasive approach. The surgical procedures can be explained in detail during a consultation at our Endometriosis Centre.

There are currently no strong recommendations regarding alternative treatments (traditional Chinese medicine, nutrition, electrotherapy, acupuncture, physiotherapy, sport, healthy lifestyle, kinesitherapy) based on scientific evidence. However, these supportive treatments aimed at reducing pain, improving general well-being or increasing the chances of pregnancy are valuable.

Approximately 60-70% of patients with endometriosis are able to carry a pregnancy to term spontaneously.

If surgical treatment or advanced symptoms of the disease suggest a significant obstacle to conception, our team can offer a specialist consultation at the Fertility Unit. We collaborate with the reproductive medicine unit at the CHUV in Lausanne.