Endometriosis in Italy: 1.8 million women live with the chronic disease
Endometriosis represents one of the most complex and underestimated gynecological challenges of our time. The most recent data from the Istituto Superiore di Sanità confirm that approximately 1.8 million Italian women currently live with a diagnosis of endometriosis , with a prevalence of 1.4% of the female population between 15 and 50 years of age , which places this pathology among the most widespread in the gynecological field.
A phenomenon that silently affects millions of women, often for years without a correct diagnosis, causing not only intense physical pain but also significant repercussions on fertility and quality of life.
The numbers of endometriosis in Italy: an alarming epidemiological pictureAccording to data from the Istituto Superiore di Sanità, in the last ten years over 113,000 incident hospitalizations for endometriosis have been recorded with an incidence rate of 0.82 cases per 1,000 resident women of childbearing age [1]. Globally, the World Health Organization estimates that endometriosis affects approximately 10% of the female population of reproductive age , affecting approximately 190 million women in the world [2].
Italian data show slightly higher rates in the autonomous province of Bolzano, in Veneto and Sardinia [1]. Particularly significant is the data relating to the impact on fertility: 30-40% of women suffering from endometriosis may experience fertility problems or subfertility [3].
The Causes of Endometriosis: A Multifactorial PuzzleEndometriosis is a chronic gynecological disease characterized by the presence of endometrial tissue outside the uterine cavity . Endometrial tissue, which normally lines the inside of the uterus, develops in abnormal locations such as the ovaries, fallopian tubes, peritoneum, bladder and intestine [4].
Main risk factors
- Premature menarche : first menstruation at a young age;
- nulliparity : absence of pregnancies carried to term;
- genetic factors : positive family history in 30% of cases;
- environmental factors : exposure to pollutants with endocrine disrupting action.
Preliminary studies conducted by the ISS highlight that the risk of endometriosis could be associated with residence in areas contaminated by persistent pollutants such as polychlorinated biphenyls, dioxins, lead and cadmium [1].
Recognizing Endometriosis: Symptoms and ManifestationsEndometriosis presents a characteristic symptomatic picture. The classic symptomatic triad includes dysmenorrhea, dyspareunia and infertility [5].
Main symptoms
- Severe dysmenorrhea : severe menstrual pain that progressively worsens.
- Chronic pelvic pain : which persists even outside of the menstrual period.
- Deep dyspareunia : pain during sexual intercourse.
- Gastrointestinal symptoms : pain during defecation, abdominal swelling.
- Urinary symptoms : pain during urination.
- Chronic fatigue : persistent tiredness.
Classification by stages
The American Society for Reproductive Medicine (ASRM) classifies severity into four stages [6]:
- Stage I (minimal) : Limited superficial lesions.
- Stage II (mild) : More numerous and deeper lesions.
- Stage III (moderate) : Ovarian endometriomas and adhesions.
- Stage IV (severe) : extensive lesions with dense adhesions.
Endometriosis can have a devastating impact on quality of life . It is considered a disease of social relevance , since in its most severe forms it significantly limits women's work productivity [3].
Patients report:
- work limitations : absenteeism and reduced productivity;
- impairment of social relationships : isolation and relational difficulties;
- impact on intimate life : couple problems due to dyspareunia;
- mood disorders : anxiety and depression secondary to chronic pain;
- fertility concerns : stress related to difficulties in conceiving;
The average diagnostic delay of 7-10 years further compounds the psychological impact, leaving women without answers for long periods [7].
Diagnosis of endometriosis: criteria and diagnostic toolsThe diagnosis of endometriosis is mainly clinical and can be made from puberty until menopause [8].
The diagnostic pathway includes:
Diagnostic approach
- accurate anamnesis : detailed collection of symptoms and family history;
- gynecological examination : objective evaluation of the pelvic structures;
- transvaginal ultrasound : first instrumental examination with accuracy greater than 80%;
- magnetic resonance imaging : gold standard for lesion mapping;
- CA-125 dosage : nonspecific marker but useful for monitoring;
- laparoscopy : definitive diagnostic confirmation when necessary.
It is essential to consult a gynecologist specialist when the following occur:
- severe menstrual pain that does not respond to common painkillers;
- persistent pelvic pain outside of menstrual periods;
- pain during sexual intercourse that interferes with intimate life;
- cyclical gastrointestinal symptoms associated with the menstrual cycle;
- difficulty conceiving after 6-12 months of trying;
- progressive worsening of symptoms over time.
Early recognition of endometriosis allows you to:
- start appropriate treatments before the disease progresses;
- preserve fertility through timely interventions;
- prevent complications such as extensive adhesions;
- significantly improve the quality of life;
- receive adequate psychological support from the early stages.
Endometriosis is one of the main causes of female infertility . The mechanism of impairment is multifactorial:
- anatomical alterations : adhesions that modify the pelvic anatomy;
- chronic inflammation : hostile environment for gametes and embryos;
- ovarian impairment : reduced ovarian reserve;
- tubal alterations : impairment of oocyte transport.
For women seeking pregnancy , specialist monitoring of ovarian function and timely assessment of reproductive options are essential.
How to book a gynecological visitFor those who suspect they have endometriosis or need a specialist gynecological check-up, booking a visit is now easier and faster thanks to digital platforms.
On Doctolib.it you can:
- Find gynecologists specializing in endometriosis in your area.
- Book visits based on the availability of specialists.
- Choose the date and time that best suits your commitments.
- View the doctor's specific expertise in endometriosis.
- Manage appointments directly online with automatic reminders.
The platform provides access to a network of qualified specialists, facilitating access to gynecological care when you need it most.
Sources
[1] Istituto Superiore di Sanità. "Endometriosis: more than 1,800,000 women live with a diagnosis in Italy", 2025.
[2] Italian Endometriosis Foundation. "Endometriosis affects approximately 10% of women of reproductive age globally", March 2025.
[3] Ministry of Health. "28 March 2025 World Endometriosis Day", March 2025.
[4] Humanitas. "Endometriosis: what it is and what are the symptoms", April 2025.
[5] MSD Manuals Professional Edition. "Endometriosis - Gynecology and Obstetrics", April 2024.
[6] American Society for Reproductive Medicine (ASRM). "Classification of Endometriosis," International Guidelines.
[7] ISS. "For over 134 thousand women between 15 and 50 years old at least one hospitalization for endometriosis between 2011 and 2020", December 2024.
[8] IFEM Endo. "Diagnosis of endometriosis", May 2024.
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