Endometriosis in Badalona

Endometriosis is a common and often underdiagnosed condition: severe period pain is not “normal” and deserves to be investigated. At Badagine we assess each case individually, with a structured clinical evaluation and gynecological ultrasound, to give you a clear diagnosis and a treatment plan adapted to you.

What is endometriosis?

It is a chronic condition in which tissue similar to the endometrium (the lining of the inside of the uterus) grows outside the uterine cavity: on the ovaries, the peritoneum, the fallopian tubes or, in deep forms, on structures such as the bowel or the bladder. It affects roughly 10% of women of reproductive age and is one of the most frequent causes of chronic pelvic pain.

Types of endometriosis

Not all endometriosis is the same. Three main forms are described, and they can coexist in the same patient:

Why it appears and which factors are associated

The exact cause is unknown. The most widely accepted theory is retrograde menstruation (part of the menstrual blood flows back through the tubes into the pelvis), although it happens in many women who never develop the disease; other factors therefore play a role, such as genetic predisposition, the immune response and the effect of oestrogens, on which the disease depends. Associated factors include:

• A first-degree relative with endometriosis.
• Early first period.
• Short menstrual cycles.
• Heavy or prolonged periods.

Having none of these factors does not rule out the disease, and endometriosis is not the result of anything the patient has done or failed to do.

Most common symptoms

• Severe period pain (dysmenorrhoea) that limits usual activities.
• Chronic pelvic pain, also outside the period.
• Pain during sex (dyspareunia).
• Pain when opening the bowels or passing urine, especially during the period.
• Heavy periods or irregular bleeding.
• Difficulty getting pregnant.
• Persistent tiredness.

The intensity of symptoms does not always match the extent of the disease: some women have mild lesions and a lot of pain, and others have extensive disease and few symptoms.

Endometriosis in teenagers

It can begin in the first years after the first period. Severe period pain that means missing school, that does not improve with usual painkillers or that comes with digestive or urinary symptoms deserves a gynecological assessment: it should not be taken as “normal” or left to pass with age. In teenagers, the aim is to control pain, protect quality of life and follow the situation over time, with an especially careful approach to treatment decisions.

How it is diagnosed

Diagnosis starts with a detailed clinical history and a gynecological examination. The most recent clinical guidance, such as that published by ACOG in 2026, stresses a structured evaluation and avoiding unnecessary delays when symptoms fit. Transvaginal gynecological ultrasound can identify endometriomas (ovarian cysts) and help assess suspected deep lesions; when needed, the study is completed with other imaging tests.

Some tests under investigation, such as saliva tests or bowel-signal tests being evaluated by NICE in the United Kingdom, do not yet replace a gynecological assessment. A normal test result does not rule out the disease either, so clinical evaluation remains the cornerstone of diagnosis.

A diagnosis that often takes time

In many studies, the time between the onset of symptoms and diagnosis is measured in years. Reasons include the normalisation of period pain, the variety of symptoms (which can be mistaken for digestive or urinary problems) and the fact that superficial forms are not always seen on imaging. That is why, with persistent symptoms, it is worth seeking advice early and keeping a record.

How to prepare for your first visit

If you can, bring this information; it will help us understand your case better:

• A symptom diary covering 2 or 3 cycles: date, pain intensity (0 to 10), relation to the period, bleeding, and digestive or urinary symptoms.
• Previous reports, ultrasound scans or MRI results, and the treatments you have already tried and how you responded.
• Family history of endometriosis or other gynecological conditions.
• Your questions and goals: pain control, wish to become pregnant, fear of surgery…

At the visit we take a detailed clinical history, carry out a gynecological examination and, if appropriate, a transvaginal ultrasound. With the results we explain the options and decide on the plan together.

Treatment options

There is no single treatment: it is decided together with the patient according to her symptoms, the location of the lesions, her age and whether she wishes to become pregnant.

• Pain control with painkillers, anti-inflammatories and supportive measures.
• Hormonal treatment to reduce disease activity: contraceptives, progestogens and, in selected cases, more recent options such as oral GnRH receptor antagonists, approved by the EMA.
• Minimally invasive surgery when indicated, for example for endometriomas, deep lesions or lack of response to medical treatment. More information on gynecological surgery.

Pelvic pain is complex and can involve nervous-system mechanisms in addition to the visible lesion, so it should be assessed as a whole and the response to treatment reviewed.

Self-care and quality of life

These measures complement, but do not replace, medical treatment:

• Local heat (hot-water bottle or heating pad) on the lower abdomen during pain episodes.
• Regular, moderate physical activity, adapted to how you feel.
• Pelvic floor physiotherapy when there is chronic pelvic pain or pain during sex.
• A balanced diet: no diet cures the disease, and evidence for specific diets is limited.
• Emotional support: living with chronic pain affects mood and rest; asking for professional help or patient associations is part of looking after yourself.
• Regular check-ups to review the response to treatment.

Endometriosis and fertility

Having endometriosis does not mean you cannot get pregnant, but in some cases it can make it harder. The presence of an endometrioma alone does not determine the strategy: ovarian reserve, the size and location of the lesion, symptoms and the reproductive plan are assessed together. If you are trying to conceive, it is best to plan it with your gynecologist.

Myths and facts

When to seek advice?

• If period pain stops you living normally or you need medication every month.
• If you have persistent pelvic pain or pain during sex.
• If you have been trying to get pregnant for some time without success.
• If you have been told it is “normal” and symptoms continue.

This page is for information only and does not replace a medical consultation. Content reviewed by Dr. D. Barazi del Pino, specialist in Obstetrics and Gynecology, COMB member no. 41308.