PCOS & endometriosis

The exact causes are still being studied. Several theories coexist:

• The retrograde flow: During menstruation, blood comes up through the tubes towards the pelvic cavity.
• Genetic factors: There is often a higher risk if a close relative is affected.
• Environmental factors: Research is exploring the impact of endocrine disruptors.

It can appear as soon as first period (menarche) and manifest throughout genital life, until menopause. Diagnosis is often made between the ages of 25 and 35, but symptoms frequently begin in adolescence.

We generally distinguish:

1. Superficial (peritoneal) endometriosis: Endometrial fragments on the abdominal wall.
2. Ovarian endometriosis: Presence of cysts on the ovaries (endometriomas).
3. Deep endometriosis: The lesions infiltrate more than 5 mm deep or affect other organs (bladder, colon).

There is no proven direct causal link, but these two pathologies are central sensitization syndromes. They share chronic pain. Patients with endometriosis are statistically at a higher risk of developing fibromyalgia, possibly due to exhaustion of the nervous system from repeated pain.

The main warning sign is pain that disrupts daily life :

• Uncomfortable periods (not passing with paracetamol).
• Discomfort during sexual intercourse.
• Digestive or urinary problems during cycles.
• Chronic fatigue.

To date, we do not speak of definitive “cure” in the medical sense, because it is a chronic illness. However, we can take care of it very well. The objective of the supports is to stop the progression of the lesions and to eliminate the discomfort to regain a normal quality of life.

The classification (often that of AFS) is based on the extent of the lesions:

• Stage 1 (Minimal): Some superficial implants.
• Stage 2 (Mild): More numerous and slightly deeper implants.
• Stage 3 (Moderate): Presence of adhesions and ovarian cysts.
• Stage 4 (Severe): Deep lesions, significant adhesions and multi-organ damage.

Note: The stage does not define the intensity of the pain (a stage 1 may be more uncomfortable than a stage 4).

If your period discomfort prevents you from going to work or having a normal social life, it's not "normal." The only way to know is to consult a specialized gynecologist to have a endovaginal ultrasound or a Pelvic MRI performed by a radiologist expert in endometriosis.