Endometriosis
Endometriosis
is the presence of endometrial glandsE and stroma in any extrauterine site, and may be sus-pected based
on history, symptoms, and physical examination as well as laboratory and
imaging informa-tion. Like the endometrial tissue from which it is derived,
endometriosis implants and cysts respond to the hormonal fluctuations of the
menstrual cycle. Laparotomy or laparos-copy may reveal lesions consistent with
endometriosis, but because lesions may be small or atypical or caused by
pathology other than endometriosis, only
proven tissue biopsydiagnosis is diagnostic. Many women with endometriosis
areasymptomatic, and diagnosis is confirmed only when sur-gery is
performed for other indications.
It is estimated that 7% to 10% of
women in the gen-eral population have endometriosis. Pelvic endometriosis is
present in 6% to 43% of women undergoing steriliza-tion, 12% to 32% of women
undergoing laparoscopy for pelvic pain, and 21% to 48% of women undergoing
laparoscopy for infertility. Endometriosis usually occurs in women of reproductive
age, and is less frequently found in postmenopausal women. Endometriosis occurs
more often in women who have never had children.
Some evidence suggests that
endometriosis may have a genetic component. Women with first-degree relatives
with endometriosis have nearly a 10-fold increased risk of developing
endometriosis. The proposed mechanism of inheritance is polygenic and
multifactorial.
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