Endometriosis: what you need to know before making important decisions
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Medically reviewed by
Prof. Olivier Donnez
Updated on
August 6, 2026
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Have you been offered surgery?
Have you been offered surgery?
Surgery is never trivial. A medical specialist will analyze your file to confirm the recommendation or explore other therapeutic options.
Is there an alternative to surgery?
Is there an alternative to surgery?
A surgeon specializing in your condition will re-evaluate your file to confirm if surgery is necessary or to identify less invasive solutions.
Have you been presented with several treatment options?
Have you been presented with several treatment options?
Have you been presented with several treatment options?
An expert physician will analyze your medical records and history to help you choose the most appropriate strategy for your situation, whether it be medical treatment, surgery, or monitoring.
Torn between two treatments?
Torn between two treatments?
A specialist will explain exactly what each option entails, including effectiveness, side effects, and daily impact, so you can make your decision with confidence.
Still unsure about your diagnosis?
Still unsure about your diagnosis?
Still unsure about your diagnosis?
A specialist doctor will analyze your complete file (tests, imaging, medical history) to provide you with a reasoned diagnosis and guide your care.
Have you just received a diagnosis?
Have you just received a diagnosis?
Have you just received a diagnosis?
Have your medical file reviewed by a specialist in your condition. You will receive an additional opinion in less than 7 days, helping you move forward with clarity.
Is your condition rare or complex?
Is your condition rare or complex?
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When facing cancer or a serious illness, every decision counts.
When facing cancer or a serious illness, every decision counts.
A doctor at an expert center will review your file to confirm your care plan, clarify the available options, and help you make decisions with confidence.
Have you received a diagnosis or been offered a treatment plan?
Have you received a diagnosis or been offered a treatment plan?
Have you received a diagnosis or been offered a treatment plan?
Submit your file in just a few minutes and get an expert opinion in under 7 days.
Have you received a diagnosis or been offered a treatment plan?
Submit your file in just a few minutes and get an expert opinion in under 7 days.
What is a medical second opinion?
What is a medical second opinion?
Following a diagnosis or a proposed treatment plan, a medical specialist can analyze your file and provide an additional perspective.
Your health insurance may cover your second opinion.
Your health insurance may cover your second opinion.
Many partner health insurance providers cover the Diagdoor service with no upfront costs. Check your eligibility as soon as you create your account.
Are you looking for a second opinion for a loved one?
Are you looking for a second opinion for a loved one?
The process is entirely online. Upload your available medical documents, and our team will take care of the rest.
How does a second opinion work on Diagdoor?
How does a second opinion work on Diagdoor?
Upload your medical documents online; our team will review your file within 48 hours, and an expert will provide their opinion in less than 7 days. Simple, secure, 100% online.
Not sure if your case is eligible?
Not sure if your case is eligible?
Our medical team can guide you before you submit your request. Describe your situation, and we will help you determine if Diagdoor can be of assistance.
Need the opinion of a
[spec]
Need the opinion of a
[spec]
Upload your file to Diagdoor. A
[spec]
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analyzes it and provides a reasoned opinion in less than 7 days.
For years, intense period pain is often dismissed without considering endometriosis. Yet, this disease affects approximately 1 in 10 women of reproductive age, and it takes an average of 8 years to diagnose in France. Its complexity lies in the variability of its forms and symptoms, which differ from one woman to another.
Key points
- Endometriosis is a chronic condition: cells similar to those of the uterine lining (the endometrium) grow outside the uterine cavity, causing inflammation and pain.
- It affects approximately 1 in 10 women of reproductive age and often remains undiagnosed for many years.
- The intensity of symptoms varies from one woman to another and does not necessarily reflect the extent of the lesions.
- Treatment is tailored to each individual situation: the location of the lesions, the intensity of symptoms, life goals, or even infertility.
Endometriosis: a chronic disease with multiple forms
Endometriosis develops when cells similar to those of the endometrium (the lining that covers the inside of the uterus) attach themselves outside the cavity of this organ. Subject to the hormonal variations of the menstrual cycle, these cells thicken and then bleed, causing local inflammation, adhesions, and pain. The disease is benign (it is not cancerous) but can be debilitating in daily life.
There are four main forms:
- Superficial endometriosis: lesions on the surface of the peritoneum, the most common form
- Ovarian endometriosis: endometriotic cysts on one or both ovaries, known as endometriomas
- Deep infiltrating endometriosis: lesions that penetrate surrounding organs (uterosacral ligaments, rectum, bladder, ureters), the most complex form to diagnose and treat
- Adenomyosis: lesions located within the muscle of the uterus itself (myometrium)
Adenomyosis is often associated with endometriosis but is a distinct medical entity. The location and depth of the lesions vary considerably from one woman to another, which is what makes interpreting imaging exams particularly demanding in terms of expertise.
1 in 10 women
of reproductive age is affected by endometriosis
8 years
average diagnostic delay in France
68.3%
of diagnosed patients are between 25 and 49 years old
Varied symptoms that are not always easy to link together
Endometriosis can cause intense pelvic pain during periods (dysmenorrhea), during sexual intercourse (dyspareunia), or persistently throughout the cycle. Some women also experience digestive or urinary symptoms: bloating, bowel issues, or pain during urination. Others discover the disease during an infertility workup without having experienced significant pain. The intensity of symptoms does not always reflect the extent of the lesions.
A diagnosis based on specialized imaging
The diagnostic process begins with a gynecological exam and a transvaginal pelvic ultrasound performed by an experienced practitioner. A pelvic MRI is then prescribed to assess the location and depth of the lesions. The quality of the interpretation of these exams depends directly on the radiologist's expertise: the same scan can lead to different conclusions depending on the reader. In complex diagnostic situations, a saliva test (Endotest®) has been available since 2024 as part of the HAS innovation package. This device is currently undergoing clinical evaluation: the results of a prospective study are expected before its definitive role in the diagnostic pathway can be established.
Treatments adapted to each situation and life plan
There is no single treatment for endometriosis: care is tailored based on symptoms, the location of the lesions, and each patient's life goals. Hormonal medical treatment is generally the first step to relieve pain and slow the progression of the disease. Surgery is considered in specific situations: deep forms with organ involvement, infertility, or when medical treatment is ineffective. It must be performed in centers with a specialized team, particularly when neighboring organs are involved.
When a second opinion can clarify the decision
Several situations may lead to seeking a second opinion during the endometriosis journey: imaging results that conflict with symptoms, proposed surgery, or ineffective ongoing treatment. A radiologist specializing in pelvic imaging can review MRI images without the need for a repeat exam and provide insight into lesions that are difficult to identify. Before a major surgical decision, an expert gynecological surgeon can also help assess whether the procedure is the best option for your situation. This process is accessible online, without the need to travel, and is covered by most health insurance plans.
Frequently Asked Questions
What exactly is endometriosis?
Endometriosis is a chronic disease in which cells similar to those of the uterine lining grow outside the uterus. These cells react to the hormones of the menstrual cycle, causing inflammation, pain, and sometimes adhesions.
How do you know if you have endometriosis?
The first signs are often intense pain during periods or sexual intercourse, or digestive and urinary symptoms linked to the cycle. An imaging assessment (endovaginal ultrasound and pelvic MRI), performed by a specialized practitioner, is the gold standard for establishing a diagnosis.
What is the difference between endometriosis and adenomyosis?
Endometriosis refers to lesions located outside the uterus, on the peritoneum, ovaries, or neighboring organs. Adenomyosis refers to the infiltration of endometrial cells into the uterine muscle itself; the two diseases can coexist but are distinct medical entities.
Can endometriosis be cured?
Yes, some cases of endometriosis can be completely eradicated. Available treatment options allow for the control of symptoms and the preservation of fertility in the majority of situations. Management evolves throughout a patient's life: medical treatments, surgery, and support for pregnancy planning if necessary.
What are the 4 types of endometriosis?
A distinction is made between superficial endometriosis (lesions on the surface of the peritoneum), ovarian endometriosis (endometriomas or cysts), deep infiltrating endometriosis (involvement of neighboring organs), and adenomyosis (lesions in the uterine muscle). These forms can coexist in the same patient.
Need the opinion of a
gynecologist
Upload your file to Diagdoor. A
gynecologist
specialist
of endometriosis
analyzes it and provides a reasoned opinion in less than 7 days.
Sources
- Ameli.fr, Endometriosis: definition and contributing factors, 2026
- Inserm, Endometriosis Dossier, 2024
- Institut Pasteur, Endometriosis: symptoms, treatment, prevention, 2024
- Strasbourg University Hospital, What is endometriosis?, 2025
- Montpellier University Hospital, Endometriosis, general overview
- HAS, Management of endometriosis, 2018
- HAS, Complex diagnosis of endometriosis: Endotest® saliva test, 2024
- EndoFrance, French association for the fight against endometriosis
Further Reading
Why get a second opinion?
Understand the situations in which a second opinion can help you confirm a diagnosis or guide your treatment plan.
How does it work?
Understand the situations in which a second opinion can help you confirm a diagnosis or guide your treatment plan.
Did you know?
Have you been offered surgery?
Have you been offered surgery?
Surgery is never trivial. A medical specialist will analyze your file to confirm the recommendation or explore other therapeutic options.
Is there an alternative to surgery?
Is there an alternative to surgery?
A surgeon specializing in your condition will re-evaluate your file to confirm if surgery is necessary or to identify less invasive solutions.
Have you been presented with several treatment options?
Have you been presented with several treatment options?
Have you been presented with several treatment options?
An expert physician will analyze your medical records and history to help you choose the most appropriate strategy for your situation, whether it be medical treatment, surgery, or monitoring.
Torn between two treatments?
Torn between two treatments?
A specialist will explain exactly what each option entails, including effectiveness, side effects, and daily impact, so you can make your decision with confidence.
Still unsure about your diagnosis?
Still unsure about your diagnosis?
Still unsure about your diagnosis?
A specialist doctor will analyze your complete file (tests, imaging, medical history) to provide you with a reasoned diagnosis and guide your care.
Have you just received a diagnosis?
Have you just received a diagnosis?
Have you just received a diagnosis?
Have your medical file reviewed by a specialist in your condition. You will receive an additional opinion in less than 7 days, helping you move forward with clarity.
Is your condition rare or complex?
Is your condition rare or complex?
Diagdoor gives you access to a doctor who specializes in your condition to confirm your treatment plan, no matter where you live.
When facing cancer or a serious illness, every decision counts.
When facing cancer or a serious illness, every decision counts.
A doctor at an expert center will review your file to confirm your care plan, clarify the available options, and help you make decisions with confidence.
Have you received a diagnosis or been offered a treatment plan?
Have you received a diagnosis or been offered a treatment plan?
Have you received a diagnosis or been offered a treatment plan?
Submit your file in just a few minutes and get an expert opinion in under 7 days.
Have you received a diagnosis or been offered a treatment plan?
Submit your file in just a few minutes and get an expert opinion in under 7 days.
What is a medical second opinion?
What is a medical second opinion?
Following a diagnosis or a proposed treatment plan, a medical specialist can analyze your file and provide an additional perspective.
Your health insurance may cover your second opinion.
Your health insurance may cover your second opinion.
Many partner health insurance providers cover the Diagdoor service with no upfront costs. Check your eligibility as soon as you create your account.
Are you looking for a second opinion for a loved one?
Are you looking for a second opinion for a loved one?
The process is entirely online. Upload your available medical documents, and our team will take care of the rest.
How does a second opinion work on Diagdoor?
How does a second opinion work on Diagdoor?
Upload your medical documents online; our team will review your file within 48 hours, and an expert will provide their opinion in less than 7 days. Simple, secure, 100% online.
Not sure if your case is eligible?
Not sure if your case is eligible?
Our medical team can guide you before you submit your request. Describe your situation, and we will help you determine if Diagdoor can be of assistance.
Need the opinion of a
gynecologist
Need the opinion of a
gynecologist
Upload your file to Diagdoor. A
gynecologist
specialist
of endometriosis
analyzes it and provides a reasoned opinion in less than 7 days.
