Endometriosis: Epidemiology, Diagnosis and Clinical Management

Abstract

Purpose of review Endometriosis is a disease of adolescents and reproductive-aged women characterized by the presence of endometrial tissue outside the uterine cavity and commonly associated with chronic pelvic pain and infertility. Here we review the epidemiology of endometriosis as well as potential biomarkers for detection and with the goal of highlighting risk factors that could be used in combination with biomarkers to identify and treat women with endometriosis earlier.. Recent findings Early age at menarche, shorter menstrual length, and taller height are associated with a higher risk of endometriosis while parity, higher body mass index (BMI) and smoking are associated with decreased risk. Endometriosis often presents as infertility or continued pelvic pain despite treatment with analgesics and cyclic oral contraceptive pills. Summary Despite a range of symptoms, diagnosis of endometriosis is often delayed due to lack of non-invasive, definitive and consistent biomarkers for diagnosis of endometriosis. Hormone therapy and analgesics are used for treatment of symptomatic endometriosis. However, the efficacy of these treatments are limited as endometriosis often recurs. In this review, we describe potential diagnostic biomarkers and risk factors that may be used as early non-invasive in vitro tools for identification of endometriosis to minimize diagnostic delay and improve reproductive health of patients.

Ovarian Clear Cell Carcinoma Detected During Long-Term Management of Endometriotic Cysts in Young Patients: Possible Heterogeneity of this Tumor

“…In particular, at outpatient gynecologic clinics, the diagnosis may be based on symptoms and the results of internal examination and TV-US [7]. Oral contraceptives are often the first-line treatment for endometriosis when patients are relatively young and unmarried [7].…”

“…In particular, at outpatient gynecologic clinics, the diagnosis may be based on symptoms and the results of internal examination and TV-US [7]. Oral contraceptives are often the first-line treatment for endometriosis when patients are relatively young and unmarried [7]. Epidemiological studies have shown that oral contraceptives prevent ovarian cancer and the risk decreases further as the age of starting contraceptive therapy declines and the duration of treatment increases [8].…”

Impact of reproductive evolutionary mismatch on women's health and the need for action and research

“…Time since the last birth increases the risk of uterine fibroids and multiparity exerts a protective effect . Early age at menarche increases the risk of endometriosis, while parity is associated with a decreased risk …”

“…11 Early age at menarche increases the risk of endometriosis, while parity is associated with a decreased risk. 12 At any age above 30 years, women who have never conceived have a lower probability of achieving a pregnancy compared with women with prior fertility. 13…”

Detection of endometriosis using immunocytochemistry of P450 Aromatase expressions in eutopic endometrial cells obtained from menstrual sloughing: A diagnostic study

“…Endometriosis is endometrium-like tissue outside uterus with similar response towards steroid hormone. [1][2][3][4] Endometriosis prevalence is approximately 5-10% of general population and it reached up to 50% in infertile women. The point prevalence of endometriosis (n = 6146, mean age 40.4±8.0 years) was 10.8 per 1000 (95% CI 10.5-11.0).…”