Endometriosis is the most common cause of persistent pelvic pain in women. Any age group can be affected. Initial medical management of painful symptoms without invasive diagnosis is appropriate.
Endometriosis, or the presence of endometrium-like glands and stroma outside the endometrial cavity, is the most common but not sole cause of persistent pelvic pain in women of reproductive age. Endometriosis is often under-recognised, and diagnostic delay may have a substantial impact on quality of life. Recent Australian data on a large cohort of women followed up over 20 years show an endometriosis prevalence of 11.4%, suggesting that more than 830,000 Australian women and girls are living with endometriosis.1 The causes of endometriosis remain unclear; however genetic factors are considered to account for 50% of causation, with biological and environmental factors contributing to the other 50%.2