Endometriosis

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Quick GuideEndometriosis Symptoms, Stages, Treatment

Endometriosis Symptoms, Stages, Treatment

What about surgery for endometriosis?

Surgical treatment for endometriosis can be useful when the symptoms are severe or there has been an inadequate response to medical therapy. Surgery is the preferred treatment when there is anatomic distortion of the pelvic organs or obstruction of the bowel or urinary tract. It may be classified either as conservative, in which the uterus and ovarian tissue are preserved, or definitive, which involves hysterectomy (removal of the uterus), with or without removal of the ovaries.

Conservative surgery is typically performed laparoscopically. Endometrial implants may be excised or destroyed by different sources of energy (e.g. laser, electrical current). If the disease is extensive and anatomy is distorted, laparotomy may be required.

While surgical treatments can be very effective in the reduction of pain, the recurrence rate of endometriosis following conservative surgical treatment has been estimated to be as high as 40%. Many doctors recommend ongoing medical therapy following surgery in an attempt to prevent symptomatic disease recurrence.

Who gets endometriosis?

Endometriosis affects women during their reproductive years. The exact prevalence of endometriosis is not known, since many women who are later identified as having the condition are asymptomatic. Endometriosis is estimated to affect over one million women (estimates range from 3% to 18% of women) in the United States. It is one of the leading causes of pelvic pain and it is responsible for many of the laparoscopic procedures and hysterectomies performed by gynecologists. Estimates suggest that 20% to 50% of women being treated for infertility have endometriosis, and up to 80% of women with chronic pelvic pain may be affected.

While most cases of endometriosis are diagnosed in women aged 25 to 35 years, endometriosis has been reported in girls as young as 11 years of age. Endometriosis is rare in postmenopausal women. Studies further suggest that endometriosis is most common in taller, thin women with a low body mass index (BMI). Delaying pregnancy until an older age, never giving birth, early onset of menses, and late menopause all have been shown to be risk factors for endometriosis. It also is likely that there are genetic factors which predispose a woman to developing endometriosis, since having a first-degree relative with the condition increases the chance that a woman will develop the condition.

Can endometriosis be prevented?

Because the cause of endometriosis is poorly understood, there are no known ways to prevent its development.

What is the prognosis for a woman with endometriosis?

Endometriosis is most commonly a disease of the reproductive years, and symptoms usually go away after a woman reaches menopause. For women experiencing symptoms, a number of therapies are available to provide relief. For infertility associated with endometriosis, treatments are also available to help increase a woman's chances of conception.

REFERENCES:

Medscape. Endometriosis.



UpToDate. Patient information: Endometriosis (Beyond the Basics).

Medically Reviewed by a Doctor on 10/7/2016

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