Endometriosis is defined as the presence of normal endometrial mucosa (glands and stroma) abnormally implanted in locations other than the uterine cavity. Ectopic endometrial tissues are most commonly located in the dependent portions of the female pelvis (eg, posterior and anterior cul-de-sac, uterosacral ligaments, tubes, ovaries), but any organ system is potentially at risk. These ectopic foci respond to cyclic hormonal fluctuations in much the same way as intrauterine endometrium, with proliferation, secretory activity, and cyclic sloughing of menstrual material. The products of this metabolic activity, including the concentrated and cyclic release of cytokines and prostaglandins, lead to an altered inflammatory response characterized by neovascularization and fibrosis formation. Some investigators have been able to demonstrate abnormal T- and B-cell function, abnormal complement deposition, and altered interleukin (IL)-6 production in women with this disease. Endometriosis can cause pain ? sometimes severe ? especially during your period. Fertility problems also may develop.
The primary symptom of endometriosis is pelvic pain, often associated with your menstrual period. Although many women experience cramping during their menstrual period, women with endometriosis typically describe menstrual pain that's far worse than usual. They also tend to report that the pain has increased over time. Common signs and symptoms of endometriosis may include: Painful periods (dysmenorrhea), Pain with intercourse, Pain with bowel movements or urination, Excessive bleeding, Infertility, etc. Treatment for endometriosis is usually with medications or surgery. Pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs), ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, others) helps and ease painful menstrual cramps. Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. Hormonal therapies used to treat endometriosis include: Hormonal contraceptives, Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists, Medroxyprogesterone, Danazol etc.
Endometriosis occurs in 7-10% of US women in the general population, and approximately 4 per 1000 women are hospitalized with this condition each year. The exact incidence in the general population is unknown, because the definitive diagnosis requires biopsy or visualization of the endometriotic implants at laparoscopy or laparotomy. It is an estrogen-dependent disease and, thus, usually affects reproductive-aged women. This condition has a prevalence rate of 20-50% in infertile women, but it can be as high as 80% in women with chronic pelvic pain. It is largely confined to women of reproductive age with an active hypothalamic-pituitary-ovarian axis. Pelvic endometriosis typically occurs in women aged 25-30 years. Extrapelvic manifestations of this disorder occur in woman aged 35-40 years.