Methods :
Observational studies (9) have highlighted many situations in which
endometriosis fails to explain certain symptoms:
- In most cases, all images and laparoscopies provide normal results in
cases of very severe primary dysmenorrhoea in young girls.
- Many patients are seen for endometriosis-like symptoms, but all
examinations, images, and laparoscopies appear normal.
- Other patients who have undergone complete surgical treatment for
their endometriosis continue to have the same ”endometriosis-like”
symptoms.
- Some patients who have recovered from their painful symptoms following
treatment for endometriosis, return for a suspected endometriosis
recession when pelvic pain and dysmenorrhoea recur, but no
endometriosis is found.
- One report concerns patients complaining of unexplained deep
dyspareunia with a painful uterus, even though the examinations,
images, and laparoscopies provided normal results.
These different findings suggest that we need to find an alternative
explanation, consider a paradigm shift, and may even need to rethink the
entire issue.