Deep endometriosis: what it is, symptoms and treatment

Deep endometriosis is the most severe form of endometriosis, which occurs when endometrial tissue is spread over a larger area, in addition to being thicker than normal.

Women with deep endometriosis have the classic symptoms of endometriosis, but more intensely, including very heavy menstrual cramps, heavy menstruation and pain during intercourse, for example.

In deep endometriosis, large amounts of endometrial tissue grow outside the uterus, in places such as the intestines, ovaries, fallopian tubes or bladder, causing progressive pelvic pain during menstruation.

main symptoms

The main symptoms of deep endometriosis are:

• Intense menstrual cramps;
• Abundant menstruation;
• Pain during or after sexual intercourse;
• Difficulty urinating;
• Pain in the lower back;
• Anal bleeding during menstruation.

In addition to these symptoms, deep endometriosis can also make pregnancy difficult. See the implications of endometriosis in pregnancy.

Is deep endometriosis serious?

Deep endometriosis is serious as it affects a larger area compared to “normal” endometriosis. In this way, the symptoms presented by the woman are more intense, so that the woman can have a lot of colic and intense bleeding, which can have consequences for her health.

Therefore, in the presence of signs and symptoms possibly indicative of deep endometriosis, it is important that the gynecologist is consulted so that the diagnosis can be made and the most appropriate treatment initiated.

Online symptom test

If you think you may have endometriosis, select your symptoms to find out what the odds are:

How to confirm the diagnosis

The diagnosis of deep endometriosis is based on symptoms and the performance of diagnostic tests, such as videolaparoscopy, barium enema, colonoscopy, CT scan, ultrasound and/or MRI.

All diagnostic methods are effective in identifying changes related to the female reproductive system, however videolaparoscopy and ultrasound are the most used methods because they have greater sensitivity and efficiency. Learn more about tests for the diagnosis of endometriosis.

How is the treatment done?

Treatment for deep endometriosis must be established by the gynecologist and aims to relieve symptoms, prevent their recurrence and improve the woman’s quality of life. Treatment should take into account the woman’s age, desire to become pregnant, symptoms, and the severity of endometriosis.

Most of the time, it is done with the use of anti-menopause medication or the use of analgesics and anti-inflammatory drugs, such as ibuprofen or naproxen, to relieve pain, especially during menstruation.

In case drug treatment is not enough, or if deep endometriosis is severe, the doctor may still recommend surgery, as it is the only way to remove endometrial tissue.

Surgery for deep endometriosis

Surgery for deep endometriosis aims to remove excess endometrial tissue, relieving symptoms. In most cases, endometriosis surgery is conservative, that is, only foci of endometriosis are removed, however, in the case of deep endometriosis, removal of the uterus may be necessary. Understand how endometriosis surgery is performed.

Watch the video with Dr. Helizabet Ribeiro, a gynecologist specializing in endometriosis who clarifies all doubts about this disease: