Main symptoms
- •Disabling cyclic pelvic pain
- •Painkiller-resistant dysmenorrhoea
- •Dyspareunia (painful intercourse)
- •Painful defecation/urination during periods
- •Heavy menstrual bleeding
- •Chronic fatigue
- •Infertility (30-50%)
- •Cyclic digestive disturbances
Risk factors
- ⚠️ Family history (×7)
- ⚠️ Early menarche (< 12)
- ⚠️ Short cycles (< 28 days)
- ⚠️ Heavy periods
- ⚠️ Nulliparity
- ⚠️ Uterine anomalies
Management and treatments
**No cure**. **Symptomatic**: NSAIDs, paracetamol. **Hormonal**: continuous oestroprogestin or progestin contraception (dienogest/Visanne), GnRH agonists (leuprorelin). **Laparoscopic surgery**: lesion excision, adhesiolysis (CHUs and private clinics). **Assisted reproduction** if infertility. ALD recognition possible for severe forms.
Prevention
No primary prevention. Early screening: consult a gynaecologist if disabling painful periods, dyspareunia, infertility > 1 year. Endovaginal ultrasound + pelvic MRI. Psychological support, EndoMaroc association.
Frequently asked questions
How is it diagnosed?+
History + clinical exam + endovaginal ultrasound + MRI. Laparoscopy with biopsy is the gold standard.
Does it cause infertility?+
Not always. 30-50% infertility. Treatment + ART achieve pregnancy in 60-70% of cases.
Does pregnancy cure it?+
No but hormonal pause improves symptoms temporarily. Recurrence possible.
When to consider surgery?+
Hormonal therapy failure, desire for pregnancy with infertility, deep lesions.