Endometriosis epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
Overview
Epidemiology and Demographics
Epidemiology
Endometriosis can affect any woman, from premenarche to postmenopause, regardless of her race, ethnicity or whether or not she has had children. Endometriosis often persists after menopause. Endometriosis in postmenopausal women is an extremely aggressive form of this disease characterized by complete progesterone resistance and extraordinarily high levels of aromatase expression. [1] A majority of 50 postmenopausal women diagnosed with endometriosis had no previous history of the disease. In less common cases, girls may have endometriosis before they even reach menarche.[2][3]
Current estimates place the number of women with endometriosis at between 5% and 20% of women of reproductive age. About 30% to 40% of women with endometriosis are infertile, making it one of the leading causes of infertility. However, endometriosis-related infertility is often treated successfully with surgical destruction of the disease. Some women do not find out that they have endometriosis until they have trouble getting pregnant. While the presence of extensive endometriosis distorts pelvic anatomy and thus explains infertility, the relationship between early or mild endometriosis and infertility is less clear. The relationship between endometriosis and infertility is an active area of research.
Early endometriosis typically occurs on the surfaces of organs in the pelvic and intraabdominal areas. Health care providers may call areas of endometriosis by different names, such as implants, lesions, or nodules. Larger lesions may be seen within the ovaries as endometriomas or chocolate cysts (They are termed chocolate because they contain a thick brownish fluid, mostly old blood). Endometriosis may trigger inflammatory responses leading to scar formation and adhesions. Most endometriosis is found on structures in the pelvic cavity:
- Ovaries
- Fallopian tubes
- The back of the uterus and the posterior culdesac
- The front of the uterus and the anterior culdesac
- Uterine ligaments such as the broad or round ligament of the uterus
- Intestines, particularly the appendix
- Urinary bladder
Endometriosis may spread to the cervix and vagina or to sites of a surgical abdominal incision. In extremely rare cases, endometriosis areas can grow in the lungs or other parts of the body.
Surgically, endometriosis can be staged I-IV (Revised Classification of the American Society of Reproductive Medicine).
References
- ↑ "Aromatase Expression in Postmenopausal Endometriosis". Aromatase in Aging Women. Medscape. 1999. Retrieved 2007-9-23. Text " Serdar E. Bulun, M.D., Hironobu Sasano, M.D. and Evan R. Simpson, Ph.D. " ignored (help); Check date values in:
|accessdate=(help) - ↑ Batt RE (2003-12-01). "Endometriosis from thelarche to midteens: pathogenesis and prognosis, prevention and pedagogy". Journal of pediatric and adolescent gynecology. 16 (6): 337&ndash, 47. PMID 14642954. Retrieved 2006-04-15. Unknown parameter
|coauthors=ignored (help) - ↑ Marsh EE (2005-03-01). "Endometriosis in premenarcheal girls who do not have an associated obstructive anomaly". Fertility and sterility. 83 (3): 758&ndash, 60. PMID 15749511. Retrieved 2006-04-15. Unknown parameter
|coauthors=ignored (help)