Health and Me

Supriya Ramesh

THIS Disease Silently Destroys Fertility And Damages Organs

Credits: Canva, iStock

When you think of endometriosis, the image that typically comes to mind is a woman doubled over in pain, battling fatigue or struggling with <a href="https://www.healthandme.com/health/infertility">infertility</a>. But for a significant portion of women, this chronic condition creeps in silently, without a single symptom to give it away. Known as asymptomatic or silent endometriosis, this elusive form can cause severe and irreversible damage before it is ever detected.

Endometriosis is commonly linked with menstrual pain, tiredness, and fertility problems. But asymptomatic or silent endometriosis is a type of condition that is much more insidious. It does not come with the familiar warning signals, so it becomes more difficult to identify and, worse, more likely to lead to long-term damage.

No Pain, But Plenty of Harm

"Since there is no pain or any apparent symptoms, the disease tends to silently grow, spreading outside the reproductive system," explains Dr. Smeet Patel, endometriosis specialist at Mayflower Women’s Hospital, Ahmedabad.

In its advanced stages, silent endometriosis does not stop at the ovaries or uterus. It can, over time, infiltrate major organs like the colon, bladder, and even deep pelvic tissues. "In a few advanced conditions, it can migrate up to the parametrium, internal vessels, or S2–S3 segment of the spine, invading the sciatic nerve and generating extreme complications," he says.

"What is especially dangerous about silent endometriosis is that its very first symptom is usually infertility," warns Dr. Smeet Patel. "By the time a woman presents to us with a fertility evaluation, the disease has already begun to deplete her ovarian reserve, reduce egg quality, or occlude her fallopian tubes—all without so much as a twinge or an early warning sign."

The disease progresses with no outward signs, which makes it incredibly deceptive. It is worth mentioning that nobody actually knows why certain people are experiencing severe pain and others experience nothing at all. However, the expert says if a patient is going for IVF or there is a family history of endometriosis, they always keep in mind the possibility of having a hidden case.

"It is difficult to diagnose," Dr. Smeet Patel admits. "Laparoscopy is still the gold standard, but high-resolution MRIs and transvaginal ultrasounds sometimes can catch indicators."

He explains that treatment is highly individualised. "The treatment is customised based on the goals of the patient—whether that is pain management, fertility, or prevention of complications down the line. For women not attempting to get pregnant, we might observe the condition closely instead of performing surgery at once. However, if fertility is an issue, early treatment—hormonal treatment, laparoscopic surgery, or assisted reproduction methods—can be a game-changer in results."

What Dr. Smeet Patel always tells his patients is this: silence does not mean peace. Just because your body is not shouting does not mean it is not sending signals. "The more aware we become of silent endometriosis, the better we can protect reproductive health and improve quality of life before irreversible damage occurs," he says.

Dr.  Sanjay Patel, endometriosis surgeon, points out the hidden nature of this condition. He explains that while most cases present with pain and discomfort, silent endometriosis does not. Patients can appear and feel perfectly healthy as the disease advances within. "About 20–25 per cent of endometriosis patients are asymptomatic. These individuals are often found accidentally during operations for other conditions or upon seeking treatment for infertility," he says.

The actual risk is with the delay. "When we do find it, it might already have affected fertility, caused adhesions, or invaded important organs. Rarely, it can invade the bowel or bladder with dangerous consequences," Dr. Sanjay Patel warns.

He also touches on the psychological toll. "Psychologically, it is confusing to patients—being told you have a disease you never had can be difficult to accept."

And for those who think they are in the clear because they feel fine, Dr.  Sanjay Patel offers a word of caution: "If there is a family history, trouble getting pregnant, or unexpected cysts on routine imaging, we must explore further. Just because it does not hurt does not mean it is not bad."

Health Conditions A-Z

health

silent endometriosis

asymptomatic

infertility

reproductive health

laparoscopy

organ damage

pelvic tissues

endometriosis specialist

hormonal treatment

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When you think of endometriosis, the image that typically comes to mind is a woman doubled over in pain, battling fatigue or struggling with infertility. But for a significant portion of women, this chronic condition creeps in silently, without a single symptom to give it away. Known as asymptomatic or silent endometriosis, this elusive form can cause severe and irreversible damage before it is ever detected. Endometriosis is commonly linked with menstrual pain, tiredness, and fertility problems. But asymptomatic or silent endometriosis is a type of condition that is much more insidious. It does not come with the familiar warning signals, so it becomes more difficult to identify and, worse, more likely to lead to long-term damage.No Pain, But Plenty of Harm"Since there is no pain or any apparent symptoms, the disease tends to silently grow, spreading outside the reproductive system," explains Dr. Smeet Patel, endometriosis specialist at Mayflower Women’s Hospital, Ahmedabad.In its advanced stages, silent endometriosis does not stop at the ovaries or uterus. It can, over time, infiltrate major organs like the colon, bladder, and even deep pelvic tissues. "In a few advanced conditions, it can migrate up to the parametrium, internal vessels, or S2–S3 segment of the spine, invading the sciatic nerve and generating extreme complications," he says.First Clue: Infertility"What is especially dangerous about silent endometriosis is that its very first symptom is usually infertility," warns Dr. Smeet Patel. "By the time a woman presents to us with a fertility evaluation, the disease has already begun to deplete her ovarian reserve, reduce egg quality, or occlude her fallopian tubes—all without so much as a twinge or an early warning sign."The disease progresses with no outward signs, which makes it incredibly deceptive. It is worth mentioning that nobody actually knows why certain people are experiencing severe pain and others experience nothing at all. However, the expert says if a patient is going for IVF or there is a family history of endometriosis, they always keep in mind the possibility of having a hidden case. Difficult to Detect"It is difficult to diagnose," Dr. Smeet Patel admits. "Laparoscopy is still the gold standard, but high-resolution MRIs and transvaginal ultrasounds sometimes can catch indicators."He explains that treatment is highly individualised. "The treatment is customised based on the goals of the patient—whether that is pain management, fertility, or prevention of complications down the line. For women not attempting to get pregnant, we might observe the condition closely instead of performing surgery at once. However, if fertility is an issue, early treatment—hormonal treatment, laparoscopic surgery, or assisted reproduction methods—can be a game-changer in results."What Dr. Smeet Patel always tells his patients is this: silence does not mean peace. Just because your body is not shouting does not mean it is not sending signals. "The more aware we become of silent endometriosis, the better we can protect reproductive health and improve quality of life before irreversible damage occurs," he says. A Hidden 25%Dr.  Sanjay Patel, endometriosis surgeon, points out the hidden nature of this condition. He explains that while most cases present with pain and discomfort, silent endometriosis does not. Patients can appear and feel perfectly healthy as the disease advances within. "About 20–25 per cent of endometriosis patients are asymptomatic. These individuals are often found accidentally during operations for other conditions or upon seeking treatment for infertility," he says.The Danger of DelayThe actual risk is with the delay. "When we do find it, it might already have affected fertility, caused adhesions, or invaded important organs. Rarely, it can invade the bowel or bladder with dangerous consequences," Dr. Sanjay Patel warns.He also touches on the psychological toll. "Psychologically, it is confusing to patients—being told you have a disease you never had can be difficult to accept."And for those who think they are in the clear because they feel fine, Dr.  Sanjay Patel offers a word of caution: "If there is a family history, trouble getting pregnant, or unexpected cysts on routine imaging, we must explore further. Just because it does not hurt does not mean it is not bad."