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Feature Article

Endometriosis: an overlooked condition

Cecilia HM Ng, Ian S Fraser

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Abstract

Endometriosis is a progressive disease in most women and remains a challenging condition. It is greatly underdiagnosed, especially in adolescents, primarily because of its variable presentation and the need for laparoscopy for diagnosis. Management is aimed at relieving pain, increasing fertility and preventing recurrence.

Key Points

  • Endometriosis is often overlooked in women with pelvic pain and causes substantial morbidity.
  • It is greatly underdiagnosed, especially in adolescents, with an average delay to diagnosis of eight to 12 years.
  • Diagnosis requires the demonstration by laparoscopy and peritoneal biopsy of endometriotic tissue lesions or nodules outside the uterus.
  • Clinical presentation of endometriosis is highly variable with respect to age at symptom onset, symptom profile, anatomical site of disease, response to treatment, and likelihood of and time to recurrence.
  • Surgical and/or medical management needs to be individualised for optimal management of pain and infertility.
  • Pregnancy usually temporarily ameliorates endometriosis symptoms, but is not a cure for the condition.

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