Endometriosis is a chronic inflammatory disease in which there is a proliferation of endometrial glands and stroma outside the uterine cavity. It occurs in about 10 to 15% of women of reproductive age and in 70% of those with chronic pelvic pain. Endometriosis is one of the main causes of infertility of unexplained origin, and it usually takes between 8 and 10 years to make a definitive diagnosis – an average of 7.5 years. In most cases, it is asymptomatic. There are many theories about the development of endometriosis, as well as factors that increase the risk of its occurrence. Endometriosis is a disease that affects many organs, which is why there are different forms. The localization of endometrial lesions in the small pelvis is the most common – the so-called. pelvic form of endometriosis, in which the internal sex organs (ovaries, fallopian tubes) and the peritoneum are affected. In addition to pelvic, there is also extrapelvic endometriosis, and according to its macroscopic nature, endometriosis can be superficial peritoneal, ovarian and deep infiltrating endometriosis. Each of these macroscopic forms is distinguished by certain marks – for example, the presence of the so-called is characteristic of the ovarian form. “chocolate cysts” of the ovaries, so called because they are filled with old blood. It has been established that there are risk factors that increase the possibility of developing endometriosis. Among these factors are early menarche (appearance of first menstruation before the age of 11); heavy and painful menstruation; short menstrual cycle (less than 27 days); the intake of alcohol and caffeine; tall female patients; nulliparous patients. In addition to risks, there are also protective factors that have been found to reduce inflammatory processes and the risk of developing endometriosis. The first such factor is the so-called tubal ligation, in which the fallopian tubes are ligated, thereby blocking retrograde menstruation, which is believed to be an etiological factor in endometriosis. Other protective factors are breastfeeding, taking oral contraceptives, smoking, regular physical activity, taking omega-3 fatty acids. The protective function of these factors is explained by the reduced levels of estrogens. An interesting fact is that smoking reduces the risk of endometriosis by about 80%, while passive smoking increases this risk. In addition to risk factors, there are also several theories for the occurrence of endometriosis: 1. Sampson’s implantation theory – this theory explains the implantation of endometrial cells in the peritoneal cavity, which got there during retrograde menstruation. Retrograde menstruation is a phenomenon in which there is a reflux of menstrual blood from the fallopian tubes to the peritoneal cavity; 2. Metaplastic theory – this theory explains the occurrence of endometriosis with the ability of the parietal epithelium to differentiate into endometrial under the action of growth factors and cytokines; 3.Metastatic theory – according to it, invasion of endometrial tissue outside the uterus is associated with lymphatic and blood metastases of endometrial cells; 4. Hormonal theory – in it, the development of endometriosis is due to increased levels of estrogens and low levels of progesterone; 5. Immunological theory – patients with endometriosis have increased levels of inflammatory markers such as interleukin-1, interleukin-6, interleukin-8, which lead to the activation of macrophages and the development of a systemic inflammatory reaction. What symptoms can lead to the diagnosis of endometriosis? In a large percentage of cases, endometriosis is asymptomatic. In the presence of symptoms, characteristic symptoms are intermenstrual bleeding, heavy and painful menstruation (dysmenorrhea), pain and burning during urination (dysuria), pain during intercourse (dyspareunia), chronic pelvic pain, infertility. Extragenital symptoms include pain during defecation (dyschesia), cyclic intestinal disturbances, hematuria, regurgitation, etc. Diagnosing endometriosis is not an easy task. The main diagnostic method is conventional laparoscopy with material biopsy. Diagnostic methods include ultrasound examination, which can detect “chocolate” cysts; nuclear magnetic resonance of a small pelvis for differential diagnosis with tumor formations; palpation – bimanual, rectovaginal, abdominal. Examination of tumor marker CA 125 is not specific enough, because the marker may be elevated in other pathologies. Treatment of endometriosis can be divided into two types – surgical and medical. The first line of pharmacological therapy includes non-steroidal anti-inflammatory drugs, progesterone preparations and combined oral contraceptives. In addition, gonadotropin-releasing hormone agonists and aromatase inhibitors are also administered. Surgical treatment is related to the removal of endometriosis foci, the laparoscopic method being preferred as it is less invasive, with a better postoperative recovery period and less pain.rectory, etc. Diagnosing endometriosis is not an easy task. The main diagnostic method is conventional laparoscopy with material biopsy. Diagnostic methods include ultrasound examination, which can detect “chocolate” cysts; nuclear magnetic resonance of a small pelvis for differential diagnosis with tumor formations; palpation – bimanual, rectovaginal, abdominal. Examination of the tumor marker CA 125 is not specific enough, as the marker may be elevated in other pathologies as well. Treatment of endometriosis can be divided into two types – surgical and medical. The first line of pharmacological therapy includes non-steroidal anti-inflammatory drugs, progesterone preparations and combined oral contraceptives. In addition, gonadotropin-releasing hormone agonists and aromatase inhibitors are also administered. Surgical treatment is related to the removal of endometriosis foci, the laparoscopic method being preferred as it is less invasive, with a better postoperative recovery period and less pain.rectory, etc. Diagnosing endometriosis is not an easy task. The main diagnostic method is conventional laparoscopy with material biopsy. Diagnostic methods include ultrasound examination, which can detect “chocolate” cysts; nuclear magnetic resonance of a small pelvis for differential diagnosis with tumor formations; palpation – bimanual, rectovaginal, abdominal. Examination of the tumor marker CA 125 is not specific enough, as the marker may be elevated in other pathologies as well. Treatment of endometriosis can be divided into two types – surgical and medical. The first line of pharmacological therapy includes non-steroidal anti-inflammatory drugs, progesterone preparations and combined oral contraceptives. In addition, gonadotropin-releasing hormone agonists and aromatase inhibitors are also administered. Surgical treatment is related to the removal of endometriosis foci, the laparoscopic method being preferred as it is less invasive, with a better postoperative recovery period and less pain.