LUNA explains: Endolike, “like endometriosis”?

The endolike is an entity that is not really defined in science and literature, and is nevertheless very often encountered in gynecological consultations.

A woman can present all the symptoms of endometriosis, without it being confirmed, particularly by imaging examinations: pelvic endovaginal ultrasound and pelvic MRI.

There are several hypotheses that can explain pain related to the menstrual cycle, without having endometriosis:

1. Primary dysmenorrhea: this is a very painful menstrual cycle during the first period. However, this pain stops in post-adolescence, or around the age of 20. This is due to hormonal immaturity, which results in a very inflammatory menstrual cycle. However, in this situation, the young patient usually has little or no symptoms such as malaise, nausea or vomiting, bloating or truancy.
2. Signs or symptoms highly suggestive of endometriosis, associated with general digestive and urinary signs, and very severe fatigue. In this situation, if the imaging tests (MRI and ultrasound) do not show any signs, it is not excluded that you may have endometriosis. In fact, all women with real endometriosis in later life describe the presence of very significant pain from adolescence and young adulthood. It is therefore difficult not to mention the diagnosis of endometriosis, despite negative imaging, without knowing your future. This is the typical picture of what can be called Endolike.
3. If you have real pain suggestive of endometriosis with negative imaging, in the context of examinations carried out outside a specialized center. In this situation, which also corresponds to a so-called Endolike buffer zone, it will be necessary to repeat the imaging examinations depending on the symptomatology and the presence of a highly specialized imaging center nearby.
4. If you have early adenomyosis, not very visible on imaging, more or less associated with polycystic ovarian syndrome PCOS. This is a fairly frequent situation that is currently being described in the scientific literature, and now benefits from technological improvements in imaging for its detection.

It is necessary to mention the improvement of imaging techniques from year to year. This notion is very important because the relevance and specificity of the images make it possible to better diagnose endometriosis lesions that are fine and small in diameter.

For this reason, it is necessary to remember that images are very effective in showing ovarian cysts (endometriomas), or deep and voluminous endometriosis, reaching the vagina, the rectum, the bladder and other digestive organs, but will remain less effective for the diagnosis of adenomyosis and superficial endometriosis. This diagnostic difficulty with imaging must be taken into account in order not to rule out a diagnosis of endometriosis.

Obtaining an “Endolike” diagnosis allows for better monitoring of your pain, as well as the recording and evolution of all your symptoms that may actually trigger endometriosis. In the future, with the help of artificial intelligence, this method will make it possible to predict not only the evolution of endometriosis, but also the phenotype of the disease and the risk to your fertility that this endometriosis implies.

The Endolike also allows for the implementation of a treatment that is substantially similar to that used to treat endometriosis on a medical level. Indeed, hormonal and analgesic treatments, as well as all the support actions such as dietetics, yoga, sports activity, micronutrition, etc. can often have the same beneficial effects as for endometriosis. It is indeed urgent to reduce your pain, even if you are not a “real” endometriosis patient.

Women suffering from menstrual cycle pain are a real public health issue. Being considered an “Endolike” allows access to simple and effective treatments, to avoid hypersensitivity, as well as the appearance of anxiety creating a change in cyclical behavior, which could worsen the pain.