Prof. Dr. Mauricio Abrão
CRM-SP 52.842
Gynecology and Endometriosis
Medical specialty
Endometriosis: diagnosis, treatment and specialized care
Endometriosis is a chronic condition that can cause intense pain, bowel or urinary changes, impact on sexual life and difficulty getting pregnant. Investigation and treatment should consider your symptoms, the extent of the disease and your reproductive plans.
In-person care in Sao Paulo and teleconsultation for patients from other states and countries.
Specialized care for endometriosis
Clínica Medicina da Mulher brings together specialists in gynecology, endometriosis, human reproduction, pain management, urogynecology, imaging and gynecological surgery to assess each case individually.
You can also meet the medical team at Clínica Medicina da Mulher.
What is endometriosis?
Endometriosis happens when tissue similar to the endometrium develops outside the uterus. This condition may cause inflammation, pelvic pain, severe cramps, pain during sexual intercourse, bowel or urinary symptoms with a cyclical pattern, and difficulty getting pregnant.
Endometriosis is a chronic gynecological condition in which tissue similar to the endometrium appears outside the uterus and may cause pain, cyclical symptoms and impact on fertility. Each case needs to be assessed individually.
When is it important to investigate the possibility of endometriosis?
Intense and recurrent pain deserves investigation. Endometriosis can appear differently in each patient, and the assessment should consider symptom pattern, frequency and impact on daily life.
- Cramps that interrupt work, studies or daily activities.
- Frequent pelvic pain, even outside the menstrual period.
- Pain during or after sexual intercourse.
- Pain when having a bowel movement or urinating during menstruation.
- Cyclical bowel or urinary bleeding.
- Difficulty getting pregnant.
- Symptoms that persist even after conventional treatment for cramps.
This list does not replace a medical assessment and does not confirm a diagnosis.
How is endometriosis diagnosed?
Clinical assessment
The consultation considers symptoms, menstrual history, the impact of pain on daily life, sexual life, fertility, previous exams and treatment goals.
Imaging exams
Imaging exams may be requested according to the medical assessment to support the investigation, identify potentially affected areas and help define the plan.
Endometriosis mapping
Endometriosis mapping helps assess potentially affected areas and may guide treatment planning when indicated.
How is endometriosis treatment defined?
Treatment is individualized. The definition considers symptoms, location and extent of disease, response to previous treatments, impact on quality of life and the desire to get pregnant now or in the future.
Clinical treatment
In some cases, clinical treatment may be used to control symptoms, especially pain, and reduce the impact of the disease on daily life. The indication depends on medical assessment.
When pain is persistent, integration with pain management.
Surgery for endometriosis
Surgery may be considered in selected cases, such as persistent pain, organ involvement, associated infertility or insufficient response to clinical treatment. The indication must be individualized after specialized assessment.
When indicated, care may involve gynecological surgery and, in specific situations, robotic surgery.
Endometriosis and fertility
Endometriosis may be associated with difficulty getting pregnant in some patients, but this does not mean that everyone will have infertility. When pregnancy is desired, follow-up should consider fertility, ovarian reserve, disease extent, age and how long pregnancy has been attempted.
Multidisciplinary care for each phase of your journey
Endometriosis can affect different areas of health and daily life. For this reason, follow-up may involve other specialties according to each patient's needs.
Gynecology
Assesses symptoms, menstrual history, exams and the initial care strategy. gynecology and obstetrics
Human reproduction
May participate when there is a desire for pregnancy, difficulty conceiving or reproductive planning needs. human reproduction and infertility
Pain management
Helps understand chronic pain, functional impact and complementary follow-up strategies. pain management
Nutrition
Can support eating habits and care routine when appropriate for the individual plan. nutrition
Urogynecology
May be considered when urinary symptoms, pelvic pain or functional changes are present. urogynecology
Pelvic physiotherapy
May be indicated for pelvic pain, muscle dysfunction or rehabilitation, according to medical and functional assessment.
Psychological support
May help when chronic pain, infertility or impact on sexual life affects emotional health and quality of life.
Gynecological surgery
Participates in selected cases in which a surgical procedure may be discussed. gynecological surgery
Coloproctology and urology
May be involved when bowel, urinary or integrated care needs are suspected.
How does the assessment work?
Specialized consultation
Listening to symptoms, clinical history, previous exams and the patient's goals.
Targeted investigation
Reviewing or requesting exams when necessary.
Individualized care plan
Defining the plan and referrals to complementary specialties when indicated.
In-person care and teleconsultation
Clínica Medicina da Mulher sees patients in person in Sao Paulo and offers teleconsultation for patients from other cities, states and countries, according to each case.
Patients living outside Sao Paulo can also consult information about international service.
Frequently asked questions about endometriosis
Endometriosis is a condition in which tissue similar to the endometrium develops outside the uterus. It may cause inflammation, pelvic pain, severe cramps, pain during sex, cyclical bowel or urinary symptoms and difficulty getting pregnant. Symptoms vary, so medical assessment is important.
Common symptoms include severe cramps, persistent pelvic pain, pain during or after sex, pain when having a bowel movement or urinating during menstruation, and difficulty getting pregnant. Some patients also have cyclical bowel or urinary changes. These signs alone do not confirm a diagnosis.
No. Severe cramps may have different gynecological or non-gynecological causes. Endometriosis is one possibility when pain is recurrent, progressive, limiting or appears with other symptoms, such as pain during sex or cyclical bowel changes. Diagnosis depends on medical assessment.
Diagnosis begins with a detailed consultation, considering symptoms, menstrual history, pain impact, sexual life, fertility, previous exams and goals. Imaging exams may be requested when indicated to support investigation and treatment planning.
Not always. Investigation may include clinical assessment and imaging exams when indicated. Surgery should not be understood as mandatory for every patient. The need for a procedure depends on symptoms, findings and treatment goals.
Endometriosis may be associated with difficulty getting pregnant in some patients, but not all patients will have infertility. When pregnancy is desired, assessment should consider age, time trying, ovarian reserve, disease extent and other reproductive factors.
Yes. There are treatment strategies, but the choice must be individualized. The plan may consider pain control, quality of life, disease extent, previous treatments and pregnancy plans. There is no single approach that fits all patients.
Surgery may be considered in selected cases, such as persistent pain, organ involvement, associated infertility or insufficient response to clinical treatment. The decision should follow specialized assessment and consider risks, benefits and patient goals.
Endometriosis mapping is an assessment designed to identify areas potentially affected by the disease. It may help treatment planning when indicated, especially in suspected deep, bowel, urinary or complex pain cases.
Teleconsultation may be an option for patients from other cities, states or countries, according to each case. It helps organize history, symptoms, previous exams and next steps. In some situations, in-person assessment or additional exams may be necessary.
Yes. In some cases, endometriosis may be associated with bowel or urinary symptoms, especially when they appear cyclically. Pain during bowel movements, pain when urinating or cyclical bleeding should be evaluated by a medical team.
Seek assessment when pain, cramps, bowel or urinary symptoms, pain during sex or difficulty getting pregnant affect your routine. You do not need to normalize symptoms that limit sleep, work, study or sexual life.
Your pain deserves specialized investigation
An appropriate assessment can help understand your symptoms, guide exams when necessary and define a care plan compatible with your routine and goals.