Introduction/Objectives: Endometriosis affects 10% of women worldwide. It is noteworthy that this condition is often accompanied by pelvic pain and stress. Endometriosis is a debilitating gynecological condition where tissue similar to the uterine lining grows outside the uterus, often causing significant pain and reproductive issues. We aimed to study the relationship between the intensity of pelvic pain, and stress and inflammatory markers in women with deep endometriosis. Methods: This cross-sectional study analyzed women diagnosed with deep endometriosis through imaging, surgery, and/or biopsy. We assessed pain using the Numerical Rating Scale (NRS). Stress was assessed with the Perceived Stress Scale (PSS-10) questionnaire and the serum cortisol levels. Additionally, we analyzed inflammatory markers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Results: Fifty-two women, with an average age of 37.8 ± 6.9 years, participated in this study. Forty-four percent of these participants demonstrated high levels of stress, as indicated by scores above 26 on the PSS-10. Those categorized with “high stress” on the PSS-10 questionnaire exhibited significantly higher pain levels compared to those with “low stress” (p < 0.05). Furthermore, patients experiencing more-severe pelvic pain (pain score > 7) had notably higher serum cortisol levels. Women with intense pelvic pain (scores above 7 on the NRS) had significantly elevated serum cortisol levels (Cohen’s d = 0.72; p = 0.018). Conclusions: A positive association was found between stress levels and the intensity of pelvic pain in women with deep endometriosis, suggesting an interconnection between emotional aspects and biological responses.

Endometriosis is a chronic, estrogen-dependent inflammatory disease influenced by complex neuroimmune interactions and pain chronification mechanisms. Modern medical management is increasingly guided by a deeper understanding of neuroinflammation, peripheral and central sensitization, and immune dysregulation, moving beyond traditional hormonal suppression. This chapter will synthesize the latest evidence on precision medicine approaches, integrating pain phenotyping, molecular and inflammatory biomarkers, and mechanisms of treatment resistance. It will explore targeted pharmacologic strategies, including neuromodulators, selective progesterone receptor modulators, immunomodulatory and anti-fibrotic agents, as well as innovative non-hormonal therapies under investigation. Additionally, it will highlight research gaps and opportunities for translational applications. The aim is to provide a rigorous, mechanism-based framework for individualized, effective, and biologically informed medical treatment of endometriosis.

Introduction: Laparoscopy has become a crucial tool in the diagnosis and treatment of gynecological acute abdomen. This minimally invasive technique not only allows for effective therapeutic interventions but also provides a reliable means of obtaining accurate diagnoses through direct visualization of abdominal and pelvic structures. It enables clinicians to identify underlying conditions, such as ectopic pregnancies, ovarian cysts, or pelvic inflammatory disease, with greater precision, reducing the need for exploratory laparotomy. This approach offers significant advantages, including reduced postoperative pain, and a shorter hospital stay. Methods: This descriptive retrospective study analyzed 39 female patients who underwent laparoscopy between 2017 and 2023, diagnosed with acute abdomen of gynecological origin, with the aim of describing the effect of laparoscopy in female patients with acute abdomen of gynecological origin, considering outcomes such as symptoms, intraoperative findings, postoperative hospital stay and complications occurring during the surgical procedure. Results: The most prevalent diagnosis was ectopic pregnancy (43.5%), followed by ruptured ovarian cyst (17.9%) and pelvic inflammatory disease (15.3%). Salpingectomy was the most common surgical procedure (48.7%), with a conversion rate to laparotomy of 10.2%. The average hospital stay was 1.9 ± 1.2 days, increasing for cases requiring surgical conversion (3.0 ± 1.8 days). Conclusion: We conclude that laparoscopy is effective in managing gynecological emergencies, providing rapid diagnoses, less invasive treatments, and shorter recovery times.