A widespread but under-recognized condition
When Juliana underwent surgery for polycystic ovaries at age 23, her Colombian doctors never mentioned endometriosis. They simply told her to monitor a cyst nearly the size of her left ovary. Five years later, after relocating to Mexico City and deciding to start a family with her husband, she finally received the diagnosis that would change everything.
During a routine examination while pregnant last summer, her gynecologist identified unusual spots requiring further evaluation by an endometriosis specialist. The discovery came as a shock to the young couple eager to become parents.
Juliana's experience mirrors that of countless women across Mexico who remain unaware they have endometriosis until fertility becomes an urgent concern. Globally, an estimated 60% of cases go undiagnosed, contributing to significant gaps between actual prevalence and detection rates.
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, causing chronic inflammation and pain. Dr. Anaïs Reyes Navarro characterizes it as a chronic disease that complicates pregnancy, though conception remains possible with proper management.
The condition affects between 176 and 200 million women worldwide, with prevalence estimates consistently ranging from 6% to 10% of women of reproductive age. In Mexico alone, approximately 7 million women live with the disease, according to health authorities.
Recent research increasingly recognizes endometriosis as an inflammatory systemic illness affecting multiple organ systems rather than just a localized pelvic condition. This explains why medical literature documents rare cases of endometrial tissue in the intestines, lungs and even brain tissue.
Common symptoms include irregular and severely painful menstruation, excessive bleeding and persistent fatigue. Yet many patients, like Juliana, experience regular cycles without extreme discomfort, delaying recognition of the underlying problem.
The diagnostic maze
Identifying endometriosis presents significant challenges for both patients and healthcare systems. In Mexico, diagnosis typically requires between seven and ten years, aligning with global research showing average delays of 6.6 to 6.8 years worldwide. International variation proves stark, ranging from six months in Brazil to 27 years in the United Kingdom.
The Revista Mexicana de Medicina de la Reproducción reports that 35% of Mexican women experiencing infertility suffer from endometriosis, underscoring the condition's impact on reproductive health.
Confirming diagnosis demands lengthy, uncomfortable and costly procedures. A single specialized ultrasound costs approximately 6,000 pesos, while magnetic resonance imaging reaches nearly 11,000 pesos. Initial diagnostic expenses in private facilities total around $1,000 USD.
Public healthcare options exist through Family Medicine Units, but scheduling tests can require two to four months or longer depending on patient loads at local clinics and referral hospitals. Many women choose private laboratories when financially feasible to avoid extended waiting periods.
Thorough examinations prove essential, as endometrial lesions may appear throughout the body. Juliana recalls her doctor requiring complete intestinal preparation with laxatives before imaging to ensure accurate results.
Laparoscopy remains the gold standard for diagnosis, offering sensitivity between 69% and 79% with specificity ranging from 83% to 94% when visual findings receive histological confirmation.
Financial and professional toll
Beyond medical costs, endometriosis exacts a substantial economic burden. Women with the condition lose an average of 6.3 to 6.4 hours of work weekly due to reduced effectiveness while working and absences, translating to annual productivity losses between $10,000 and $16,000 per patient in international studies.
In the United States, the total economic impact reaches $78 billion to $119 billion annually, with productivity losses accounting for 75% to 84% of total costs rather than direct healthcare expenses.
These figures help explain why many Mexican women, like those profiled in this article, delay motherhood to establish careers and financial stability before confronting the additional challenges endometriosis presents.
Treatment outcomes vary
Leticia discovered her condition differently. During an annual checkup, doctors identified an endometrioma measuring nearly 7 centimeters. Her initial gynecologist recommended removing one ovary, but seeking a second opinion from an endometriosis specialist preserved her fertility and enabled her to conceive her daughter.
Clinical trials show laparoscopic surgery provides pain relief for 66% to 80% of patients, though symptoms recur in 10% to 30% of treated women annually. Surgical outcomes vary significantly based on disease stage and individual patient factors.
Following her diagnosis, specialists determined Juliana had Stage 2 endometriosis with lesions on her fallopian tubes obstructing egg passage. Her gynecologist prescribed a protein-based diet low in sugars and processed foods, along with supplements. Reyes recommends incorporating strength training and regular exercise during pregnancy.
Doctors informed Juliana that pregnancy hormones sometimes cause lesions to disappear. Tragically, she lost the baby at the end of her first trimester and has not attempted to conceive again, the psychological impact proving considerable.
Demographic implications
Endometriosis may contribute to Mexico's declining fertility rates. Recent INEGI data shows population growth slowed from 1.0% annually in 2015-2020 to 0.7% in 2020-2025. Mexico City recorded the lowest state-level fertility rate at 0.8 children per woman in 2024.
These demographic shifts reflect multiple factors, including women choosing delayed motherhood to pursue professional and personal development before committing to family responsibilities.
After successfully delivering her daughter, Leticia maintains a specialized diet that alleviates symptoms. She believes the condition has not fundamentally altered her daily life or future plans. Her experience contrasts sharply with Juliana's ongoing struggle with the disease's physical and emotional aftermath.
Both women emphasize the importance of dietary management during their cycles, following protocols their specialists recommend. Drawing from her journey, Leticia strongly advises women not to skip annual checkups, even without obvious symptoms.
For Leticia, the diagnosis ultimately proved transformative in unexpected ways. She now maintains healthier habits and understands her body better than before, finding gratitude in the self-knowledge the condition forced her to develop.
