What is the science behind endometriosis ?

The disease and its mechanisms in question

Let’s pause and clarify: you might ask people around you, and nobody describes exactly the same thing. Everyone knows someone who has it, but the overall picture still feels blurry. Endometriosis affects around one in ten women of reproductive age in France in 2025 – that’s a statistic that really makes you think, isn’t it? We’re talking about the spread of tissue fragments that mimic the uterine lining, but don’t stay where they belong. They often settle on the ovaries, bladder, rectum and, sometimes, in other, rarer locations. No social group or region is spared. You can feel how the term “chronic gynaecological disease” makes sense here: yes, endometriosis is long-term, progresses quietly, destabilises, and creates deep fatigue. As for the causes, they still keep many of their secrets. There is talk of genetic predisposition, environmental factors, hormonal imbalance – and even the immune system gets involved.

Why does it take so long to get a diagnosis? You can probably guess: symptoms seep into every aspect of life, blur the lines, doctors hesitate, and patients get exhausted repeating themselves without feeling understood. The longer the doubt lingers, the heavier the consequences become. Endometriosis is not a mysterious condition that you should have to endure without explanations.

Causes and risk factors under the microscope

No one has really managed to close the debate. What stands out is this famous combination of influences. Does your mother or sister go through the same thing? Then you need to be twice as vigilant. Short cycles, heavy periods, exposure to chemicals such as endocrine disruptors – all of this falls within the scope of current hypotheses. Even early menarche is flagged as a silent warning sign. And the immune system doesn’t help when it allows lesions to progress. Still, there is no single, clear truth to hold on to: everything is intertwined, nothing can be completely isolated.

Endometriosis symptoms that must be taken seriously without delay

Far too many women endure, minimise, and push aside this chronic and invisible pain. You’ll notice: pain is only one doorway; the list doesn’t stop there. Do you recognise yourself in these symptoms that scribble all over your daily life?

Pain: a signal that no longer lies

Pain is what sounds the alarm – the one that steals your nights and ruins your days. Cycles become unforgiving: 70% of affected women report unbearable period pain, according to the association EndoFrance. Sometimes, pain appears between periods, attacks the lower back, or shows up at ovulation. There is nothing “normal” about any of this. Dyspareunia surfaces, disrupts intimate life, and creates distance that is anything but trivial.

Digestive and urinary symptoms: the trap of medical wandering

Among the signs that confuse everyone, digestive issues often take centre stage. Constipation, cyclical diarrhoea, persistent bloating, unexplained nausea – all of these appear without warning. The body sends signals that are too quickly attributed to other conditions. At the far end of the chain, some women report blood in their stool or urine, frequent urges to go to the bathroom, and discomfort that forces them to reorganise everything.

Very often, the line between endometriosis and a “simple” digestive problem blurs the diagnosis. You may know this strange feeling: one doctor hesitates, another focuses only on the intestine, and no one connects the dots easily. Logic breaks down, and trust starts to crumble.

Never underestimate a cyclical discomfort, a pain that settles in, or a digestive issue that simply won’t go away. Women are often lost among all these signals, and getting to the right specialist becomes an obstacle course.

General symptoms: when quality of life declines

What happens when fatigue becomes a constant companion, when willpower fades with every painful night? A feeling of irreversible exhaustion hangs over everything, fear of the next pain flare holds your plans back, and sleep turns into a battle. Drained of energy, you may feel yourself withdrawing from others, afraid to explain yet again, to repeat your story without getting any real response. Medical wandering eventually wears down morale; your circle of support shrinks, and silence settles in.

Atypical signs and off-the-radar situations that should never be minimised

Not all symptoms fit into the usual boxes; some completely escape attention. Have you ever heard of pain reaching up to the shoulder during your cycle? Or of coughing up blood every month? Unlikely, but it happens. Containing these atypical scenarios requires persistence – and a doctor who truly listens. Data from the Lyon University Hospital in 2024 confirm a few cases where the disease reaches as far as the thoracic cavity. It’s never a standard scenario, but it is very real.

Specific features depending on age and lesion location

Teenagers, often on the front line from the very start of puberty, are told far too often that their pain is “normal”, that they’re exaggerating. Women in their forties also discover the disease in unexpected ways, right when menopause seems just around the corner. When the digestive system is involved, transit issues dominate and can become constant. When lesions affect the ovaries, infertility becomes part of the picture. If the bladder or diaphragm are affected, the range of symptoms explodes. This complex puzzle calls for tailored medical support – there is no one-size-fits-all pathway.

What to do when symptoms suggest endometriosis

Are you starting to connect the dots? Then it’s time to talk about it openly, as soon as the suspicion takes root. Conversations with your GP or gynaecologist are crucial – every word matters here, every detail guides the clinical examination. The radiologist sometimes takes over; pelvic ultrasound is often the first step, and MRI helps refine the analysis.

Early diagnosis reduces the risk of errors, unnecessary treatments and accumulating suffering. The French Haute Autorité de Santé recommends a specialist care pathway as soon as characteristic signs appear – not only when every possible symptom has already piled up.

A few tips to become an active participant in your care journey

The day of your appointment is approaching – how do you make sure you don’t forget anything? Take a notebook and jot down your pain, its duration and frequency. List the treatments you’ve tried and your medical history, write down your questions in advance, think about possible tests, and ask whether a fertility consultation or psychological support could be helpful. This preparation – sometimes tiring – can transform the medical relationship: the diagnosis comes faster, and the care plan becomes more precise.

• Note the frequency and intensity of your pain right after each episode
• Gather all previous tests and treatments in one place
• Write down your questions before each appointment with a doctor
• Don’t forget to mention any family history of endometriosis

Clémence never forgets the time when pain floored her the day before an interview, convinced that weakness was the rule, not the exception. Two years of hesitation and silence, and then finally the right centre, the right diagnosis, and at last a concrete plan. She dares to talk about it now; her story circulates, others recognise themselves and book appointments too, feeling less alone under the weight of doubt. EndoFrance’s specialist forums are full of similar stories – sooner or later, you see yourself in one of them, and it’s a powerful moment.

Consequences and useful resources so you no longer navigate this alone

The repercussions affect intimate life, social life and professional life too. Fear of losing the ability to conceive grows: 30 to 40% of affected women face real difficulties, according to AP-HP. Psychological balance is shaken, loneliness creeps in, and depression sometimes slips into everyday life. Facing the disease alone is the real mistake to avoid. Effective care brings together different professionals: doctors, psychologists, pain specialists, and sometimes dietitians.

What are the treatments for endometriosis?

Currently, the management of endometriosis is based on three main approaches, used depending on symptoms as well as each patient’s pregnancy plans.

1. First, hormonal treatments, which mainly aim to reduce the impact of menstrual cycles on disease symptoms.
2. If pain becomes too intense and hormonal treatments are ineffective, surgery may be considered.
3. Finally, in case of a desire for pregnancy combined with infertility, medically assisted reproduction may be offered. This may include ovarian stimulation (for mild to moderate endometriosis) or in vitro fertilisation (for more severe endometriosis).

Discover natural products adapted to your needs:

Did you know? The Endotest is the first saliva test used to diagnose endometriosis, this gynaecological disease that affects 10% of women in France.

À propos de l'auteur

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Caroline Lanson

Co-founder and product manager

Caroline LANSON, co-founder of the Miyé brand, is passionate about plants and well-being: she has over 20 years of experience in developing skincare and food supplements in various laboratories and has also trained in naturopathy.