Endometriose: Da Complexidade Fisiopatológica à Medicina Personalizada — Avanços no Diagnóstico, Manejo e Desenvolvimento de Novas Estratégias Terapêuticas

In: Nursing Edição Brasileira · 2026 · vol. 32(340) , pp. 22319–22322 · doi:10.36489/nursing.2026v32i340p22319-22322 · W7220893698
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This review discusses the multifactorial pathophysiology of endometriosis, highlighting clinical heterogeneity that causes diagnostic delays and therapeutic limitations due to current treatments that control symptoms without eliminating the disease.

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This review article examines the multifactorial pathophysiology of endometriosis, highlighting its classification as a chronic, estrogen-dependent inflammatory condition characterized by ectopic endometrial-like tissue. The authors discuss how genetic, epigenetic, immunological, and metabolic alterations, alongside interactions with the microbiome and oxidative stress mechanisms, contribute to significant clinical heterogeneity and diagnostic delays. They further note that current therapeutic strategies primarily manage symptoms rather than curing the disease or preventing recurrence, underscoring the need for personalized medicine approaches. This paper is centrally about endometriosis — specifically covering its complex pathophysiology, diagnostic challenges, and the development of new personalized therapeutic strategies.

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Abstract

A endometriose é uma doença ginecológica crônica, inflamatória e estrogênio-dependente, marcada pela presença de tecido semelhante ao endométrio fora da cavidade uterina, com repercussões importantes sobre dor, fertilidade e qualidade de vida. Sua fisiopatologia é multifatorial e envolve alterações hormonais, imunológicas, genéticas, epigenéticas, inflamatórias e metabólicas, além da interação com o microbioma e mecanismos relacionados ao estresse oxidativo e à fibrose. Nesse contexto, a heterogeneidade clínica e molecular da doença contribui para atrasos diagnósticos e limitações terapêuticas, uma vez que as abordagens disponíveis frequentemente controlam os sintomas, mas não eliminam a doença nem impedem sua recorrência.
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Endometriose: Da Complexidade Fisiopatológica à Medicina Personalizada — Avanços no Diagnóstico, Manejo e Desenvolvimento de Novas Estratégias Terapêuticas DOI: https://doi.org/10.36489/nursing.2026v32i340p22319-22322Palavras-chave: Endometriose, da Complexidade Fisiopatológica à Medicina Personalizada : Avanços no Diagnóstico, Manejo, Desenvolvimento de Novas Estratégias Terapêuticas, fisiopatologiaResumo A endometriose é uma doença ginecológica crônica, inflamatória e estrogênio-dependente, marcada pela presença de tecido semelhante ao endométrio fora da cavidade uterina, com repercussões importantes sobre dor, fertilidade e qualidade de vida. Sua fisiopatologia é multifatorial e envolve alterações hormonais, imunológicas, genéticas, epigenéticas, inflamatórias e metabólicas, além da interação com o microbioma e mecanismos relacionados ao estresse oxidativo e à fibrose. Nesse contexto, a heterogeneidade clínica e molecular da doença contribui para atrasos diagnósticos e limitações terapêuticas, uma vez que as abordagens disponíveis frequentemente controlam os sintomas, mas não eliminam a doença nem impedem sua recorrência. Referências Alonso A. et al. Medical management of endometriosis. Current Opinion in Obstetrics & Gynecology. 2024;36(5):353–361. Blanco L. P.; SALMERI, N.; TEMKIN, S. M.; SHANMUGAM. 2025;K.(4):Endometriosis. Bonavina G, Taylor H. S. Endometriosis-associated infertility: from pathophysiology to tailored treatment. Frontiers in Endocrinology. 2022;13. Bulun S. E. et al. Endometriosis. Endocrine Reviews. 2019;40(4):1048–1079. França P. R. C.; LONTRA, A. C. P.; FERNANDES. 2022;27(13):D. Garcia Garcia J. M. et al. Endometriosis: cellular and molecular mechanisms leading to fibrosis. Reproductive Sciences. 2023;30(5):1453–1461. Jiang I. et al. Intricate connections between the microbiota and endometriosis. International Journal of Molecular Sciences. 2021;22(11):5644. Koninckx P. R. et al. Pathogenesis based diagnosis and treatment of endometriosis. Frontiers in Endocrinology. 2021;12. Moradi Y. et al. A systematic review on the prevalence of endometriosis in women. Indian Journal of Medical Research. 2021;154(3):446–454. Saunders P. T. K.; WHITAKER, L. H. R.; HORNE, A. W. Endometriosis: improvements and challenges in diagnosis and symptom management. Cell Reports Medicine. 2024;5(6):1–6. Tennfjord M. K.; GABRIELSEN, R.; TELLUM, T. Effect of physical activity and exercise on endometriosis-associated symptoms: a systematic review. BMC Women's Health. 2021;21(1). Zheng L. et al. New therapeutic targets for endometriosis predicted through mendelian randomization analysis and case-control trials. Frontiers in Genetics. 2025;16. Adilbayeva A, Kunz J. Pathogenesis of endometriosis and endometriosis-associated cancers. International Journal of Molecular Sciences. 2024;25(14):7624. Lamceva J, Uljanovs R, Strumfa I. The main theories on the pathogenesis of endometriosis. International Journal of Molecular Sciences. 2023;24(5):4254. Abulughod N, Valakas S, El-Assaad F. Dietary and nutritional interventions for the management of endometriosis. Nutrients. 2024;16(23):3988. Downloads Publicado Como Citar Edição Seção Licença Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.

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