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Endometriosis - Highlights

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of endometriosis

Alternative Names

Hysterectomy and endometriosis

Highlights:

Endometriosis Symptoms

Endometriosis symptoms vary widely, and sometimes do not occur at all. Symptoms can include:

Pelvic pain, especially around the time of menstruation
Pain during sexual intercourse
Heavy menstrual bleeding
Sleep problems
Cyclical abdominal pain
Intermittent diarrhea and constipation
Painful or difficult urination
Blood in the urine
Some women with endometriosis don� ' t have any symptoms of the disorder

Infertility and Endometriosis

Endometriosis rarely causes a complete inability to conceive, but it can contribute to infertility both directly and indirectly.

Treatment

Treatment options for endometriosis include:

Watchful Waiting. Delaying treatment may be most appropriate for women with mild endometriosis or those who are approaching the age of menopause.
Drugs. Hormonal drugs are used to reduce endometrial implants. These drugs include oral contraceptives, progestins, gonadotropin-releasing hormone (GnRH) agonists, and danazol. Over-the-counter nonsteroidal anti-inflammatory drugs or acetaminophen may help with pain relief.
Surgery. Conservative surgery approaches, such as laparoscopy, remove endometrial implants and cysts but do not remove reproductive organs. Conservative surgery can help improve fertility. Hysterectomy, the surgical removal of the uterus, may be recommended in severe cases of endometriosis, but it does not necessarily cure the condition.

Resources

www.asrm.com -- American Society for Reproductive Medicine
www.acog.org -- American College of Obstetricians and Gynecologists
www.endometriosisassn.org -- The Endometriosis Association
www.womenshealth.gov -- National Women's Health Information Center
www.endometriosis.org -- Endometriosis.org
www.resolve.org -- National Infertility Association

References

Bulun SE. Endometriosis. N Engl J Med. 2009 Jan 15;360(3):268-79.

Davis L, Kennedy SS, Moore J, Prentice A. Modern combined oral contraceptives for pain associated with endometriosis. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD001019.

Jacoby VL, Grady D, Sawaya GF. Oophorectomy as a risk factor for coronary heart disease. Am J Obstet Gynecol. 2009 Feb;200(2):140.e1-9. Epub 2008 Nov 18.

Johnson, N. and C. Farquhar. Endometriosis. Clin Evid. 2006;(15): 2449-64.

Lobo RA. Endometriosis. Etiology, pathology, diagnosis, management. Katz VL, Lobo RA, Lentz G, Gershenson D, eds. Comprehensive Gynecology. 5th ed. St. Louis, MO: Mosby; 2007: chap 19.

Mounsey AL, Wilgus A, Slawson DC. Diagnosis and management of endometriosis. Am Fam Physician. 2006 Aug 15;74(4):594-600.

Ortiz DD. Chronic pelvic pain in women. Am Fam Physician. 2008 Jun 1;77(11):1535-42.

Parker WH, Broder MS, Chang E, Feskanich D, Farquhar C, Liu Z, et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses' health study. Obstet Gynecol. 2009 May;113(5):1027-37.

Rodgers AK, Falcone T. Treatment strategies for endometriosis. Expert Opin Pharmacother. 2008 Feb;9(2):243-55.

Selak V, Farquhar C, Prentice A, Singla A. Danazol for pelvic pain associated with endometriosis. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD000068.

Shakiba K, Bena JF, McGill KM, Minger J, Falcone T. Surgical treatment of endometriosis: a 7-year follow-up on the requirement for further surgery. Obstet Gynecol. 2008 Jun;111(6):1285-92.

Reviewed last on: 8/5/2009
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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