Clinical aspects of endometriosis

Abstract

Endometriosis is a common, benign, estrogen-dependent, gynecological disorder associated with pelvic pain and infertility. The prevalence of this condition can reasonably be assumed to be around 10%. Endometriosis should be suspected in women with dysmenorrhea, dyspareunia, chronic pelvic pain, or subfertility; it may also be asymptomatic and can be present as a chronic disease in a subset of patients. Visual recognition during laparoscopy is required for the definitive diagnosis of endometriosis. Treatment must be individualized, taking into consideration the clinical problem in its entirety, including the impact of the disease and the effect of its treatment on quality of life. Endometriosis-associated pain can be effectively treated by surgery and by hormonal suppression. Endometriosis-associated subfertility can be effectively treated by surgery and by assisted reproduction, but not by hormonal suppression. Endometriosis can recur after treatment, and the risk increases with the severity of endometriosis and the time interval since the last surgery. However, patients with recurrent pain do not always have endometriosis and may require a multidisciplinary approach involving a pain clinic, and counseling should be considered early in the treatment plan. © Springer Science+Business Media, LLC 2010.