Endometriosis is a chronic medical condition that affects the reproductive organs. It occurs when endometrial tissue, which resembles the uterine lining, grows in abnormal places outside the uterus. This tissue may appear in various areas, including the ovaries and fallopian tubes. It often causes significant pain or discomfort, although some individuals experience mild or no symptoms; this is referred to as silent endometriosis. Detecting and treating this condition is key to reducing disease progression and preserving fertility. Here are several things to know about silent endometriosis:
It Doesn’t Show Obvious Symptoms
Unlike symptomatic endometriosis, the silent form does not cause the typical symptoms of severe pelvic pain and heavy periods. If there are signs, they are often subtle or non-specific. Fatigue, irregular spotting, and digestive issues are several possible indicators.
When present, the symptoms are mild, so they may initially be attributed to other conditions, such as hormonal imbalances or irritable bowel syndrome. Because of this, silent endometriosis takes an average of seven to 10 years to diagnose. Many individuals are also misdiagnosed, or they have to see multiple doctors before receiving an accurate diagnosis.
Other possible symptoms include pain during urination, bloating, diarrhea, and lower back pain. Discomfort while using the bathroom may be mistaken for irritable bowel syndrome or a urinary tract infection, as these conditions share similar symptoms. Lower back pain is sometimes attributed to sciatica or muscle strains. This overlap can delay proper medical care, and it allows the condition to progress unnoticed. Early testing, diagnosis, and treatment are key to preventing disease progression.
The Condition Still Causes Inflammation
Even without obvious symptoms, silent endometriosis still causes inflammation in the body. The misplaced tissue outside the uterus continues to respond to hormonal changes, particularly estrogen, just as uterine lining tissue does. These changes occur with the monthly menstrual cycle.
When the tissue reacts, the immune system recognizes it as abnormal and triggers an inflammatory response. Immune cells release inflammatory chemicals, such as cytokines and prostaglandins; these lead to swelling, irritation, and tissue changes in the surrounding area. Over time, the ongoing immune activity may also contribute to adhesions and altered function in nearby pelvic organs.
Infertility Is a Common Sign
Fertility challenges are a common sign of silent endometriosis, and the disorder is the primary cause of infertility in 30 to 50% of women. Chronic inflammation in the pelvic area alters the normal balance of hormones and chemical messengers that are key to reproduction. These changes can impact ovulation, fertilization, and implantation. Endometriosis also causes scar tissue to form in some cases. This may affect the ovaries and fallopian tubes, interfering with egg release and pickup. Scar tissue and adhesions have the potential to decrease sperm movement, making pregnancy more difficult.
A person with this condition may feel well and have regular menstrual cycles while still experiencing difficulty conceiving. This is why infertility is often one of the first recognized signs of asymptomatic endometriosis. The condition can quietly affect reproductive function long before it causes pain or other symptoms.
Protein Markers Help Detect Endometriosis
To help detect silent endometriosis, doctors are able to test for a specific protein marker, BCL6. This protein is involved in regulating inflammation, and it is highly associated with endometriosis. The test is performed through an endometrial biopsy. Doctors take a tissue sample approximately seven to 10 days after ovulation, and they send it to a lab for analysis. This timing lets clinicians evaluate BCL6 expression during the implantation window, which is when abnormal inflammatory activity may be most apparent.
If the BCL6 test results are positive, there is a 90% or greater chance that endometriosis is the cause. Individuals can then discuss further steps with their doctor. A laparoscopy is a minimally invasive surgical procedure that helps confirm an endometriosis diagnosis. The procedure lets doctors assess the extent of the condition, and it allows them to remove the abnormal tissue.
BCL6 testing can benefit those with silent endometriosis by identifying underlying inflammation when symptoms are minimal or absent. It helps reduce delays in diagnosis, and it supports more informed treatment planning. Without testing, the condition may go undetected for longer, potentially worsening fertility outcomes. BCL6 testing allows doctors to tailor interventions earlier and provide patients with clearer guidance on managing their condition.
Get Tested for Silent Endometriosis
Silent endometriosis often produces few or no obvious symptoms, and this makes it difficult to detect through routine exams or imaging. BCL6 testing helps identify underlying inflammation in the uterine lining that is associated with endometriosis, even when pain or other typical symptoms are absent. It supports proactive management of reproductive and pelvic health. If you suspect silent endometriosis or are experiencing unexplained infertility, talk to your doctor about BCL6 testing today.
Disclaimer:
This content is for general informational purposes only and is not intended as medical advice, diagnosis, or treatment. Information about endometriosis, symptoms, fertility, and testing options such as BCL6 should not replace consultation with a qualified healthcare professional. Medical conditions vary widely between individuals, and only a licensed provider can offer personalized evaluation and recommendations. If you have symptoms, concerns about fertility, or suspect endometriosis, seek guidance from your doctor or a reproductive health specialist promptly.
John