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Endometriosis - Complications

Description

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

Alternative Names

Hysterectomy and endometriosis

Complications:

Pain

Adhesions, the dense, web-like structures of scar tissue that can attach to nearby organs, can cause significant pain. Pelvic pain is the most common complaint for women with endometriosis, and it can significantly impair the quality of life, including work and social activities.

Infertility

Infertility is the main complication of endometriosis. Endometriosis is responsible for about a third of cases of female infertility. Endometriosis rarely causes an absolute inability to conceive, but it can contribute to infertility both directly and indirectly:

If implants occur in the fallopian tubes, they may block the egg's passage.
Implants that occur in the ovaries prevent the release of the egg.
Adhesions that form among the uterus, ovaries, and fallopian tubes, can prevent the transfer of the egg to the tube.

Effects on Other Parts of the Pelvic Region

Implants can also occur in the bladder (although less commonly) and cause pain and even bleeding during urination. Implants also sometimes form in the intestine and cause painful bowel movements, constipation, or diarrhea.

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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