Request a quick appointment with the specialist in Endometriosis, Dr. Lucas Minig, an expert Gynecologist Oncologist in this type of cancer that is very common in women.

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What Causes Endometriosis?

The growth of the Endometrium (cells that normally grow inside the uterus) outside of the uterus isn’t fully understood. What we do know is that it only develops when estrogen is present in a woman’s body from the start to the end of their reproductive age, as post-menopausal women rarely develop endometriosis.

There are theories that genetics could also potentially play a role in a woman’s risk of developing endometriosis.

What Is The Endometrium?

The endometrium is a layer of cells that lines the uterine wall and that sheds monthly with each period. The most common sites of endometriosis are the ovary (in the form of cysts), or the peritoneum. However, endometrial tissue can be found in odd places such as the bowel, or even in the lung, and in extremely rare cases, in the eye.

What Areas Can Be Impacted by Endometriosis?

Ovarian Endometriosis

The most frequent location of endometriosis is in the ovaries in the form of cysts with hemorrhagic content (blood accumulated over time). This is known as “endometrioma” or a “chocolate cyst” because of its similarity to the contents of the cyst.


Adenomyosis is a form of Endometriosis in which endometrial cells grow on the outside wall of the uterus, between the abdominal muscle fibers. Adenomyosis often affects women in their 30s and 40s and is commonly found in women who have had children.

Peritoneal endometriosis

Endometriosis can also be located in the peritoneum, usually in the pelvis, in the form of implants or peritoneal nodules of various sizes (commonly a few millimeters). These implants can be superficial or deep depending on their ability to be implanted in the thin layer that internally covers the pelvic organs (or peritoneum).

Ultimately, endometriosis can infiltrate different organs of the pelvis in what is called “deep endometriosis”. In these cases, the implants are usually more prominent and can be located in the recto-vaginal space, being able to infiltrate the wall of the rectum, the vagina, or both. More rarely, they can invade the wall of the bladder or ureter.


How Is Endometriosis Diagnosed?

Endometriosis is diagnosed most accurately through testing biopsied tissue samples from inside the abdomen or pelvic cavities, most often through a minimally invasive laparoscopic surgery. 

Depending on the symptoms a woman is experiencing, Endometriosis can also be diagnosed through differential diagnosis of her symptoms and suspicious results in diagnostic medical imaging reports.

What Are The Most Common Symptoms of Endometriosis?

Endometriosis as a condition is often asymptomatic in the great majority of women, and may never need to be diagnosed or may be diagnosed incidentally through an unrelated surgical procedure.

Nevertheless, some women may present symptoms that can affect their quality of life to varying degrees. The severity of the symptoms of Endometriosis does not often correlate with the severity of the disease.

Endometriosis May Cause Any Combination of the Following Symptoms:

  • Pain during periods that increases over long periods of time.
  • Chronic pelvic pain between periods
  • Pain during sexual intercourse.
  • Diarrhea or constipation, pain with defecation.
  • Rectal bleeding during menstruation.

Do you have any of these symptoms?

Therapeutic options for endometriosis

  • Oral contraceptives: to suppress ovulation and menstruation to reduce pain severity.
  • Drugs that block the production of ovarian hormones: it is a temporary treatment prescribed for 6 months. The goal is to stop the progression of the disease by producing transient menopause. It is a scarcely used treatment because of its adverse effects associated with transient menopause.
  • Surgery: it is a type of treatment also used in very selected cases. The main goal is to eliminate all the visualized endometriosis foci in the abdominal and pelvic cavities. In certain cases, ovarian cysts must also be treated with cystectomy (remove the cyst without the ovary) in selected cases. In more severe cases, a hysterectomy must be performed (removal of the uterus), or even a bowel resection or the removal of other affected organs.

We routinely perform minimally invasive laparoscopic surgery for the treatment of endometriosis.

Frequently asked questions about endometriosis

What is endometriosis?

Endometriosis is a benign and auto-limited disease. The latter means the disease disappears spontaneously with menopause, meaning with the cessation of menstrual periods.

Is endometriosis hereditary?

To this day, there is no evidence of endometriosis being hereditary, meaning there is no evidence of it being transmitted through mutations in certain genes from women to their daughters.

Can endometriosis be contagious?

Endometriosis is not a contagious disease through any route, including sexual and close contact transmission.

What are endometriosis symptoms?

Endometriosis’ main symptom is pain. The pain can appear during menses (dysmenorrhea), during sexual intercourse (dyspareunia), or during defecation (dyschezia). Additionally, some women can experience chronic pelvic pain; meaning, pain during the majority of days with exacerbation during their periods.

What consequences does endometriosis have?

Endometriosis often alters the patients’ quality of life because of the pain, which can sometimes cause absence from work or social gatherings. Furthermore, in some cases, endometriosis can make it difficult to have children.

Do all women with endometriosis have difficulty having children? Does endometriosis affect fertility?

No, only the most advanced cases have a lower probability of conceiving. In fact, more than half of the women with endometriosis can become mothers spontaneously without any type of treatment.

Why can endometriosis affect fertility?

While there is no precisely known mechanism by which endometriosis can sometimes affect fertility, it is believed that it can be associated with the presence of ovary cysts or the existence of adhesions between internal genital organs (uterus – tubes, and ovaries).

No, only the most advanced cases of endometriosis have a lower probability of conceiving. In fact, more than half of the women with endometriosis can become mothers spontaneously without any type of treatment.

When is the treatment for endometriosis necessary?

While there is no precisely known mechanism by which endometriosis can sometimes affect fertility, it is believed that it can be associated with the presence of ovary cysts or the existence of adhesions between internal genital organs (uterus – tubes, and ovaries).

Endometriosis needs to be treated only when it causes pain that alters the patient’s quality of life,  when it alters the possibility of conception, or when it causes ovary cysts of a certain size.

How is endometriosis pain treated?

The treatment of pain caused by endometriosis is initially attempted with analgesics of lesser or greater potency. If this is not enough, the second step is based on the administration of hormonal treatment aiming to control menstrual cycles. Some very selected cases often require surgical treatment.

When is surgery for endometriosis needed?

Patients with endometriosis need to undergo surgery when it causes analgesic or hormonal refractory pain; when it causes ovary cysts; or when it is responsible for difficulties in conception.

Can surgery for endometriosis be performed through minimally invasive laparoscopy?

To this day, we can operate on almost 100% of patients with endometriosis with minimally invasive laparoscopic surgery. This approach, aside from its aesthetic benefits of avoiding a big abdominal incision, has the  great advantage of a speedier recovery with less pain.

Does pregnancy cure endometriosis?

Pregnancy stops the progression of endometriosis because the woman does not have menstrual cycles or ovulation during pregnancy. Accordingly, a greater number of children is associated with a lower possibility of developing endometriosis.

Do women with endometriosis have a greater risk of ovarian cancer?

Endometriosis, a benign disease, sometimes presents as ovary cysts. These cysts can very rarely progress to ovarian cancer. Women with endometriosis have a slightly greater risk of ovarian cancer when compared to women without endometriosis.

Opinions from patients with endometriosis

Doctor Lucas Minig Specialist in Endometriosis in Valencia, Spain

Dr Lucas Minig
Dr Lucas Minig
Estimado Dr. Minig: ¡Solo quería agradecerle una vez más, no solo por hacer un trabajo tan fantástico con mi endometriosis, sino también por ser una persona realmente amable y encantadora! De verdad siempre agradeceré que me escucharan a mí ya mis inquietudes y me hicieran sentir que el proceso era como un «trabajo en equipo», en lugar de imponer y prescribir, teniendo en cuenta mis necesidades e inquietudes. ¡Eres realmente notable en muchos sentidos y absolutamente bendecido para mujeres como yo! Ponte en contacto si vienes de vacaciones a Irlanda. Todo lo mejor, Ingrid” 6 de Julio de 2022.
Paciente con enfermedad de endometriosis por Doctor Lucas
The location of my endometriosis was very fast, and the way they treated me and the speediness of the surgery were wonderful. Only thankful words to a great person and even greater professional. The care received from nurses and assistants is a 10.
Noemí G
Patient with endometriosis by Doctor Lucas
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