The Prevalence of Endometriosis in Women with Chronic Pelvic Pain

Abstract

Background: The 2004 American College of Obstetrics and Gynecology clinical management guideline states that the prevalence of endometriosis is approximately 33% in women with chronic pelvic pain (CPP). This estimate came from a review showing that 28% of adult women with CPP were found to have endometriosis. The prevalence of 28% in adult women was arrived based on a compilation of 11 published studies. Yet even within the 11 studies, the reported prevalence of endometriosis varies wildly, ranging from 2 to 74%. Such an astounding variation or heterogeneity raises the question whether it is appropriate to use a single prevalence of endometriosis for all women with CPP. Methods: We sought to identify possible sources of heterogeneities in the estimation of prevalence of endometriosis in women with CPP. We included more studies that reported prevalence estimates than the review, and examined the effect of sample size and the year of publication on the heterogeneity. Results: The year of publication is positively associated with the prevalence estimate, which may indicate an increasing awareness of various appearances of endometriosis, or the prevalence of endometriosis may have increased among women with CPP. An alternative analysis with removal of four studies reporting highest prevalence estimates indicated that sample size is negatively associated with the prevalence estimates while the year of publication became only marginally significant. Conclusions: There are identifiable sources of heterogeneity in prevalence estimates, with the year of publication, sample size, and difference in evaluation of CPP being three apparent sources. Having a single prevalence estimate for all women with CPP may be too simplistic at best. The true prevalence is very likely to be higher than 33%.

Two cases of pregnant women with ovarian endometrioma mimicking a malignant ovarian tumor

“…1 Its prevalence is approximately 33% in women with chronic pelvic pain. 2,3 Therefore, cases of ovarian endometrioma during pregnancy are not rare.…”

Innovative approach in assessing the role of neurogenesis, angiogenesis, and lymphangiogenesis in the pathogenesis of external genital endometriosis

“…According to Guo [2], the incidence of endometriosis in women with chronic pelvic pain syndrome is more than 33%. Meuleman et al in 2009 evaluated the occurrence of endometriosis in infertile women with ovulatory cycles and a healthy partner.…”

“…Thus, endometriosis is a disease that affects the majority of women of reproductive age, negatively affecting their physical, psychological, and social condition that significantly reduces the quality of life in this category of patients [1,2].…”

Thiazolidinediones as Therapy for Endometriosis: A Case Series

“…Patients are generally of reproductive age, and may present with chronic pelvic pain, dysmenorrhea, dyspareunia, or subfertility. Although the prevalence of endometriosis in the general population is estimated to be about 10% [1] , the prevalence in women with pelvic pain or subfertility is estimated to exceed 33% [2,3] .…”