Endometriosis: A Review of Clinical Diagnosis, Treatment, and Pathogenesis

Abstract

Endometriosis is a condition that affects women of reproductive age, and it is distinguished by the development of endometrial-like tissue outside the uterine cavity. It is frequently accompanied by persistent pelvic discomfort and infertility. This investigation looks into recent findings on clinical manifestation to help doctors and improve women's health. PubMed and Google Scholar were used to review on clinical diagnosis of endometriosis. The search strategy contained the terms "endometriosis" and "clinical diagnosis." All research articles published between 1960 and 2021 were included in the search. The findings were then categorized to summarize the evidence. There was a total of 29 instances of endometriosis discovered. The patients' ages varied from 20 to 45 years old, with a median of 28.8 years and a mean of 29.4±7.7 years. Dysmenorrhea is a common disorder among adolescent girls experiencing various physical and emotional symptoms which have a detrimental influence on their quality of life. In this study, scar endometriosis was shown to be the more common variety of endometriosis, with 50% of cases predominantly developing at the lower segment cesarean section (LSCS) scar site. As a result, women with endometriosis are more likely to have miscarriages, and the quality of their embryos declines as a result.

Parity, mode of birth, and long‐term gynecological health: A follow‐up study of parous and nonparous women in the Australian Longitudinal Study on Women's Health cohort

“…High progestogen levels during pregnancy(ies) might relieve the symptoms of endometriosis and thereby lead to lower prevalence in women who have given birth at least once. 23 However, women with endometriosis deal with fertility issues more often, which might explain the high prevalence of endometriosis in nonparous women. 24 In accord with previous findings, 25 we found heavy periods to be more frequent in women with four or more children, whereas the association between parity and severe period pain was less clear.…”

“…This association should be interpreted with caution. High progestogen levels during pregnancy(ies) might relieve the symptoms of endometriosis and thereby lead to lower prevalence in women who have given birth at least once 23 . However, women with endometriosis deal with fertility issues more often, which might explain the high prevalence of endometriosis in nonparous women 24 .…”

As complicações da endometriose e seus efeitos na fertilidade

“…Ainda, é uma desordem subdiagnosticada que impacta a vida das mulheres acometidas devido à alta proporção de dor pélvica crônica associada, além de dismenorreia, menorragia, dispareunia e infertilidade (CRUZ BA, et al, 2022). Diante disso, é um distúrbio que acomete cerca de 15% de mulheres em idade reprodutiva, entre estas, 70% desenvolvem dor pélvica crônica resistente e 25 a 50% infertilidade (CHAUHAN S, et al, 2022).…”

“…O tratamento da endometriose, a princípio, não é curativo, mas existem abordagens medicamentosas, como o danazol, anticoncepcionais combinados e análogos de GnRH que impedem a progresão da doença e reduzem sobremaneira seus sintomas (CHAUHAN S, et al, 2022). Como tratamento cirúrgico, é possível realizar laparoscopia associada a ressecção dos tecidos ectópicos e aderentes, de forma conservadora ou radical (NOGUEIRA ACR, et al, 2018).…”

The rising tide raises all ships

“…I was in agony. I found out that I had endometriosis, a chronic pain condition caused by tissue similar (but transcriptionally distinct) to the endometrium that grows outside of the uterus, 4,5 on the ovaries, gastrointestinal tract, urinary tract, kidneys, liver and diaphragm. 6 The current hypothesis is that endometriosis develops from mis-migrated and mis-differentiated stem cells during embryogenesis.…”