Diagnosis and management of endometriosis

Abstract

Endometriosis is a chronic, benign gynecologic condition, affecting up to 10% of reproductive-age women. It is characterized by the abnormal presence of endometrial glands and stroma outside of the uterus. Clinically, endometriosis is associated with dysmenorrhea, pelvic pain, and/or infertility. The diagnosis of endometriosis can be suggested based on history and physical examination, but the gold standard for diagnosis is histologic confirmation from a surgical biopsy. The stages of endometriosis are determined based on the extent of disease intraoperatively. However, the stages of disease do not always correlate well with symptom severity. Treatments include pain management, hormonal suppression, and/or surgical intervention. Treatment decisions must be individualized to each patient, taking into consideration her symptoms and her plans for future fertility. Endometriosis presents a challenging problem to affected women and their gynecologists. As such, there continues to be investigation into the pathogenesis and potential treatments of the condition.