This article is based on current findings and a study by Professor Philippa Saunders (PhD, FMedSci, FRSE, FCOG ad eudem, 2025), which she shared as part of her study and webinar we attended - “The Science of Endometriosis: Signs, Symptoms and Diagnostic Delays.” It reveals the often overlooked symptoms of endometriosis, the biological mechanisms of the disease and new possibilities for diagnosis and a holistic approach to treatment.
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Endometriosis is a systemic disease that affects more than 190 million women worldwide. ( 1 ) It is one of the most common conditions affecting women of reproductive age and its symptoms can significantly impair quality of life. Yet it remains frequently misdiagnosed, underestimated, and misunderstood, even in advanced healthcare systems.
However, a new scientific study by Professor Philippa Saunders offers hope. It offers a new perspective not only on the pain associated with endometriosis, but also on its diagnosis and treatment options. It could be an important step towards changing the approach to this disease.
What is endometriosis and what are its forms?
Endometriosis is a condition in which tissue similar to the lining of the uterus (endometrium) is found outside the uterine cavity. This “relocated” tissue responds to hormonal changes during the menstrual cycle. The result is recurrent inflammation, pain, and in some cases, damage to surrounding organs. ( 2 )
Endometriosis can manifest itself in different ways. We distinguish three main types of deposits:
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Superficial peritoneal lesions – inflamed or scarred areas on the peritoneum
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Endometriomas – blood-filled cysts on the ovaries, nicknamed “chocolate cysts”
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Deep infiltrating endometriosis – deposits growing between organs such as the uterus, bladder and intestines
In rare cases, foci can also appear outside the pelvis – for example, on the diaphragm, in the lungs, on the skin, or even in the brain.
Not just a gynecological problem, but a neuroinflammatory condition
New scientific findings show that although endometriosis is closely linked to the female reproductive system, it is not just a gynecological disease. Endometriosis is a neuroinflammatory condition.
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The bearings create their own nerve endings
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Immune cells amplify pain signals
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Gradually, the transmission of pain is disrupted – so-called central sensitization.
These findings help explain some symptoms—even those seemingly unrelated to the reproductive system. For example, it explains why:
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The pain can be severe even with small or invisible lesions,
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Symptoms such as fatigue , bloating or irritable bowel syndrome-like symptoms are common,
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The pain becomes chronic and can also affect brain function.
Why is pain not related to the size of the bearings?
Many women hear the phrase from their doctor, “ Everything looks fine on the ultrasound. ” Yet they experience severe, debilitating pain. Recent studies show that the size or number of placentas does not necessarily correlate with the level of pain .
While some women have large lesions and almost no symptoms, others may suffer from significant symptoms without any detectable changes. Pain is influenced by a variety of factors – inflammation, nerve growth, immune cell activity, hormonal sensitivity, and also other chronic conditions such as migraines or IBS.
What can affect endometriosis symptoms? New data also points to the role of diet
One of the important findings of a recent British study of more than 10,000 women is the growing evidence that diet can affect endometriosis symptoms. The research found that for many women, pain and fatigue worsen after consuming certain foods and drinks.
Key findings from the study:
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43% of women reported worsening symptoms after consuming gluten
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18% of women reported worsening after consuming dairy products
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13% after coffee
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12% alcohol by volume
This data does not mean that the above items cause endometriosis – but it does suggest that they may worsen symptoms in some patients. This again confirms that endometriosis is not a single disease, but a complex condition that progresses slightly differently in each woman. Therefore, it is key to seek individualized solutions – and to consider lifestyle and diet as well.
Prof Saunders added: " Women repeatedly tell us that dietary changes have helped them more than medication. It's time to listen to this form of experience."
The study also points out that an important step could be the introduction of personalized nutritional recommendations as part of the treatment of endometriosis, instead of universal advice.
Current diagnosis and treatment and their limits
Getting a diagnosis of endometriosis and subsequent treatment recommendations can be a long journey – taking up to 8 years on average. One of the main problems is the lack of reliable, non-invasive tests.
Today's diagnostic methods include:
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laparoscopy – a surgical procedure to confirm superficial lesions,
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ultrasound – detects ovarian cysts (endometriomas),
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MRI – used mainly for deep endometriosis.
However, neither method is accurate enough, so research teams are looking for new ways, such as using artificial intelligence to detect biomarkers. However, no such tests have yet reached clinical practice.
Current primary approaches to endometriosis include hormonal treatment (e.g., birth control, hormonal intrauterine devices). This form of treatment can sometimes relieve uncomfortable symptoms, but is often incompatible with plans for pregnancy. Another common method is surgical removal of endometriosis. This can help some women, but like any surgery, it also carries some risks and does not guarantee that the disease will not return. Opioids are also prescribed for pain relief , but they carry a risk of addiction and side effects, such as increased fatigue.
What awaits us next?
Scientific teams around the world are working on more accurate diagnostics and targeted treatments :
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Scientists are testing a theory stemming from a recent Japanese study about a possible link between bacteria found in the uterus and the development of endometriosis.
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The drug Dichloroacetate (DCA), originally an oncology drug, is being tested , which could reduce inflammation in endometriosis lesions, normalize cell metabolism, and inhibit the growth of lesions. The MACENDO clinical trial is also being completed, testing a new drug, Nibrosetone, for pain and lesion size.
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The use of PET-CT to map lesions throughout the body is being investigated .
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The results of a large British study on the effectiveness of surgical removal of superficial deposits are awaited.
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Research into the effects of intermittent fasting is being considered for pain and inflammation.
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The possibility of using medications for migraine or IBS in selected groups of patients is being tested .
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The team is exploring the use of AI to search for inflammatory markers and targeted treatments.
Can diet, supplements, and antioxidants help?
Clinical studies suggest that certain antioxidants may play an important role in reducing pain and inflammation in women with endometriosis. Particularly promising results are emerging for vitamin E , often in combination with vitamin C.
In one randomized study by Akbari et al., 2012 , women with endometriosis took high doses of vitamins E and C for 8 weeks. The results showed:
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significant reduction in chronic pelvic pain and dysmenorrhea ,
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decrease in levels of inflammatory markers in the body (e.g. CRP and malondialdehyde).
Similarly, a study by Santanam et al., 2013 confirmed that antioxidants such as vitamin E and N-acetylcysteine ( NAC ) can reduce oxidative stress and contribute to improving the quality of life of women with endometriosis.
Some studies suggest that long-term use of antioxidants may lead to reduced pain and inflammatory markers in women with endometriosis.
At Femvie, we recommend Endo Complex Support, which was developed in the UK in collaboration with women's health experts with over 17 years of experience. It contains vitamin E in an absorbable natural form, as well as turmeric , zinc , iron and NAC - substances that science and practice associate with a positive impact on women's health and hormonal balance.
This complex can be a valuable part of a holistic approach to endometriosis – especially when complemented by nutrition, exercise, nervous regulation, and a respectful environment.
Let's change the approach to endometriosis
Endometriosis is chronic . It is systemic . And it requires a personal, multidisciplinary approach .
And that means listening to women first, even when the test shows nothing. It is also necessary to connect gynecology with neurology, immunology and holistic care. And digital tools and AI can be used for successful diagnostics and personalized treatment.
Join the Femvie community
At Femvie, we continue to translate science into understandable language. Because every woman deserves to understand her body and be taken seriously. We stand with everyone who seeks relief, understanding, and strength on this journey.
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What else can you read on Femspace?
- Hormonal contraception through the eyes of a woman with endometriosis
- The discomfort that companies overlook: Why it's time to address menstrual pain in the workplace
- 8 myths and stereotypes about menstruation
- What is premenstrual dysphoric disorder (PMDD)?
- My girlfriend got her period. What should I (not) do?
- Menstrual symptoms you may not know about
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Sources used:
- World Health Organization (WHO). Endometriosis Fact Sheet
- Saunders, PTK, Tapmeier, TT, Greaves, E., et al. (2025). Experiences of Individuals With Endometriosis in the UK: A Cross-sectional Online Survey . JAMA Network Open , 8(4), e2831953.
- Santanam, N., Taylor, RN, Parthasarathy, S. (2013). Antioxidant supplementation reduces endometriosis-related pelvic pain in humans . Reproductive Sciences , 20(6), 646–655. PubMed
- Akbari, M., Vafa, M., Nabavi, SF, et al. (2012). Effect of vitamin E and vitamin C supplementation on oxidative stress and pain in women with endometriosis: A randomized controlled trial . International Journal of Reproductive BioMedicine , 10(6), 541–546. PubMed
- Zeller, JM, Henig, I., Radwanska, E., Dmowski, WP (2001). Enhanced peritoneal cell oxidant release in endometriosis: A possible role in the genesis of the disease . Fertility and Sterility , 76(4), 763–766. PubMed
