Obesity and diabetes medications open new pathways for the treatment of endometriosis

• This disease directly compromises female fertility and increases the risk of pregnancy complications such as preeclampsia or miscarriage.
• Endometriosis affects 14 million women in Europe. According to the World Health Organization (WHO), approximately 1 in 10 women of reproductive age is affected.
• Specialists highlight the importance of early diagnosis, fertility preservation, and a multidisciplinary approach.

Madrid, WEDNESDAY, MARCH 11, 2026

Endometriosis is a chronic, progressive, and debilitating disease that affects between 10% and 15% of the female population. Far from being a rare condition, it is estimated that more than 14 million women in Europe are affected, and according to data from the World Health Organization (WHO), approximately 1 in 10 women of reproductive age lives with this disease.

It is characterized by the presence of tissue similar to the endometrium outside the uterus, which leads to chronic inflammation, pelvic pain, and alterations in ovarian function. The condition has a direct impact on female fertility and may be involved in up to 50% of female infertility cases, while also increasing the risk of complications such as preeclampsia or miscarriage.

Endometriosis should not be viewed solely as a gynecological disease, but rather as a complex condition involving hormonal, immunological, and metabolic factors that can influence its progression and its impact on fertility. It should not be understood exclusively as a hormonal disorder, but as a systemic inflammatory process in which metabolism and immunity interact dynamically. Understanding this interaction is essential for advancing toward more effective and personalized treatments.

In a context where diagnosis often occurs late and the disease continues to affect both quality of life and fertility, improving the understanding of metabolic and inflammatory factors associated with endometrial health is crucial. Integrating new research lines through a multidisciplinary approach can help improve treatment and move toward earlier, more personalized care that addresses the real needs of each patient.

In this regard, scientific research is exploring how the metabolic environment and inflammatory status may influence the progression of various endometrial tissue disorders. Recent studies, such as one published in JAMA Network Open, have observed a reduction in the risk of developing endometrial cancer in women treated with GLP-1 agonists—medications commonly used to treat obesity and type 2 diabetes.

Currently, there are no clinical trials supporting the use of GLP-1 agonists as a specific treatment for endometriosis. However, these medications have demonstrated systemic anti-inflammatory effects, improvements in insulin resistance, and modulation of adipose tissue—factors that could indirectly influence the inflammatory microenvironment associated with the disease.

Although these are different conditions, these findings reinforce the hypothesis that the metabolic environment may play an important role in various endometrial tissue disorders, including endometriosis. Dr. Marta Romero, an Internal Medicine specialist in the Reproductive Failure Unit at IVI Madrid, explains that these findings “open an important avenue of interest, but they do not replace early diagnosis or proper gynecological management of endometriosis. However, they may become a complementary tool in selected patients.”

For patients with insulin resistance, obesity, or associated systemic inflammation, addressing metabolic factors may become a complementary therapeutic pillar within a comprehensive and personalized strategy.

In this context, Dr. Romero does not describe these treatments as a “magic pill,” but rather as “a very valuable therapeutic option when there is a clear clinical indication, within a comprehensive approach that includes early diagnosis, reproductive planning, and personalized metabolic management.”

Their use should be strictly limited to patients with well-established clinical indications and always under specialized medical supervision.

Diagnostic delay and ovarian reserve

Despite its high prevalence and reproductive consequences, endometriosis continues to be an underdiagnosed disease. The average time to obtain a diagnosis is around nine years, during which many patients consult up to five different healthcare professionals—including primary care physicians, gynecologists, and other specialists—before receiving a clear diagnosis.

This delay not only prolongs physical and emotional suffering but can also progressively compromise ovarian reserve and reproductive capacity.

For this reason, specialists emphasize the need for early diagnosis and a comprehensive approach from the first clinical suspicions. Identifying the disease in its early stages allows better control of its progression, facilitates individualized treatment planning, and, when necessary, enables fertility preservation.

As Dr. Romero explains, “oocyte vitrification offers women with endometriosis a multidisciplinary approach that not only addresses pain today but also safeguards their future chances of motherhood. Fertility preservation after diagnosis is a strategic clinical decision that allows the patient to separate the progression of the disease from her desire to become a mother.”

In certain cases, vitrification makes it possible to preserve future reproductive options, particularly when there is a risk of ovarian involvement. This is especially relevant in young women with endometriomas or those who may require ovarian surgery, situations in which ovarian reserve may be significantly affected.

This highlights the importance of early diagnosis, which makes it possible to evaluate fertility preservation strategies in time and protect oocyte quality.

Such a preventive approach is particularly important in a social context marked by the progressive delay of motherhood, while the disease may silently progress for years.