Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-02T23:32:35.324Z Has data issue: false hasContentIssue false

Chapter 3 - Endometriosis

Published online by Cambridge University Press:  25 February 2021

Siladitya Bhattacharya
Affiliation:
University of Aberdeen
Mark Hamilton
Affiliation:
University of Aberdeen
Get access

Summary

Endometriosis is a chronic oestrogen-dependent condition that affects 10% of women from puberty to menopause. It is characterised by the presence and proliferation of endometrial-like cells outside the uterine cavity, generally within the pelvis. Endometriosis can present as superficial or deep peritoneal lesions, ovarian endometrioma or deep rectovaginal disease. The two hallmark symptoms of endometriosis are pelvic pain and infertility resulting in poor quality of life. There is no correlation between the extent of the disease and severity of symptoms. The true prevalence of the condition is not known, as it requires a laparoscopy to confirm the diagnosis. It is found in up to 30% of women with infertility and in 45% of those with pelvic pain. While there are several theories of pathogenesis, an interplay of genetic, hormonal, environmental and immunological factors is implicated in the development of endometriosis in susceptible women. Symptoms are managed with a combination of hormonal treatment and laparoscopic ablation or excision of lesions for pain and usually assisted reproduction for infertility. Endometriosis is prone to recurrence after treatment, requiring multiple contacts with healthcare and repeat surgery. Management of endometriosis requires an individualised approach based on the woman’s age, predominant symptoms and priorities, which are subject to change over time.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Burney, RO, Giudice, LC., Pathogenesis and pathophysiology of endometriosis. Fertil Steril 2012;98(3):511–19.CrossRefGoogle ScholarPubMed
Dunselman, GA, Vermeulen, N, Becker, C, et al. and European Society of Human Reproduction and Embryology. ESHRE guideline: Management of women with endometriosis. Hum Reprod (Oxf), 2014;29(3): 400–12.CrossRefGoogle ScholarPubMed
Gruppo italiano per lo studio dell’endometriosi. Prevalence and anatomical distribution of endometriosis in women with selected gynaecological conditions: results from a multicentric Italian study. Gruppo italiano per lo studio dell’endometriosi. Hum Reprod (Oxf) 1994;9(6):1158–62.Google Scholar
American Society for Reproductive Medicine. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril. 1997;67(5):81721.CrossRefGoogle Scholar
Bricou, A, Batt, RE, Chapron, C. Peritoneal fluid flow influences anatomical distribution of endometriotic lesions: Why Sampson seems to be right. Eur J Obstet Gynecol Reprod Biol 2008; 138(2):127–34.CrossRefGoogle ScholarPubMed
Cramer, DW, Missmer, SA. The epidemiology of endometriosis. Ann NY Acad Sci 2002;955:1122; discussion 34–6, 396406.CrossRefGoogle ScholarPubMed
Bravi, F, Parazzini, F, Cipriani, S, Chiaffarino, F, Ricci, E, Chiantera, V, Vigano, P, La Vecchia, C., Tobacco smoking and risk of endometriosis: a systematic review and meta-analysis. BMJ Open 2014;4(12):e006325-2014–006325.CrossRefGoogle ScholarPubMed
Parazzini, F, Cipriani, S, Bravi, F, Pelucchi, C, Chiaffarino, F, Ricci, E, Vigano, P. A metaanalysis on alcohol consumption and risk of endometriosis. Am J Obstet Gynecol 2013;209(2):106.e1106.10.CrossRefGoogle ScholarPubMed
NICE (National Institute of Care and Excellence). Endometriosis: Diagnosis and management. NICE guideline NG73, September 2017.Google Scholar
Duffy, JM, Arambage, K, Correa, FJ., et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev 2014;(4):CD011031.Google Scholar
Nnoaham, KE, Hummelshoj, L, Webster, P, et al. and World Endometriosis Research Foundation Global Study of Women’s Health, Consortium. Impact of endometriosis on quality of life and work productivity: A multicenter study across ten countries. Fertil Steril 2011;96(2):366–73.e8.CrossRefGoogle ScholarPubMed
Simoens, S, Dunselman, G, Dirksen, C, et al. The burden of endometriosis: Costs and quality of life of women with endometriosis and treated in referral centres. Hum Reprod (Oxf) 2012;27(5):1292–9.CrossRefGoogle ScholarPubMed
Guo, SW., Recurrence of endometriosis and its control. Hum Reprod Update 2009;15(4):441–61.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×