ENDOMETRIOSIS: A LITERATURE REVIEW OF PATHOGENESIS, DIAGNOSIS, MANAGEMENT, AND IMPACT ON QUALITY OF LIFE

Abstract

Endometriosis is a chronic, multifactorial pathological condition characterized by the presence of endometrium-like tissue outside the uterine cavity. This condition can lead to chronic pelvic pain, dysmenorrhea, dyspareunia, infertility, psychological distress, and a reduced quality of life. The complexity of clinical manifestations and the variability of responses to therapy make endometriosis a challenge regarding diagnosis and management. This literature review aims to analyze the evolution of scientific evidence concerning endometriosis, covering its pathogenesis, clinical manifestations, diagnosis, management, quality of life, mental health, and fertility. The methodology involved a review of 15 scientific articles, consisting of 11 primary studies, 3 systematic reviews/meta-analyses, and 1 evidence-based guideline. The literature is presented narratively, identifying similarities, differences, and trends in research findings. The synthesis indicates that endometriosis has a multidimensional impact on women's health. Hormonal therapy plays a role in symptom control, while non-pharmacological interventions—such as pelvic floor physiotherapy, electrotherapy, acupuncture, and psychological interventions—show potential for reducing pain and improving quality of life. Advances in transvaginal ultrasound also offer opportunities for improved non-invasive diagnosis. Furthermore, endometriosis is associated with an increased risk of anxiety and depression and can affect reproductive outcomes and the success rates of assisted reproductive technologies. Based on these findings, endometriosis management requires an individualized, multidisciplinary, and multimodal approach that considers the patient's clinical condition, quality of life, mental health, sexual function, and reproductive goals. Further research is needed regarding non-invasive diagnosis, personalized therapy, and long-term outcomes.