At a glance - Endometriosis

Definition
- Endometrial tissue located outside the uterine cavity.

Epidemiology
- Affects up to 10 per cent of menstruating women.
- More common in women with a family history.
- More common in Caucasians.
- An early first pregnancy is protective.

Pathophysiology
- Poorly understood.
- Retrograde menstruation is thought to be a possible mechanism.

Clinical features
- May be asymptomatic.
- Typically cyclical pelvic and abdominal pain.
- Dysmenorrhoea and menorrhagia.
- Deep dyspareunia.
- Subfertility or infertility.
- Fixed retrograde uterus.

Investigations
- Laparoscopy is the investigation of choice.

Management
- Asymptomatic women do not need treatment.
- Medical treatment options comprise drugs that suppress ovarian
function, including oral contraceptives, danazol,
gonadotrophin-releasing hormones and progestogens.

Surgical treatment
- Surgical treatments aim to remove the maximum ectopic endometrial
tissue.

Special features
- Endometriosis is a chronic relapsing disorder.
- It is a surgical diagnosis.
- Differential diagnoses are irritable bowel syndrome (IBS) and pelvic
inflammatory disease.
- Symptoms do not necessarily correlate with the amount of ectopic
endometrial tissue.
- Treatment may not improve fertility.

Contributed by Dr Aziz Sheikh, professor of primary care research and development, Division of Community Health Sciences, GP Section, University of Edinburgh.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Before commenting please read our rules for commenting on articles.

If you see a comment you find offensive, you can flag it as inappropriate. In the top right-hand corner of an individual comment, you will see 'flag as inappropriate'. Clicking this prompts us to review the comment. For further information see our rules for commenting on articles.

comments powered by Disqus