{"paper_id":"0b03ac79-7d3f-4667-9a7f-84e570785057","body_text":"Published online by Cambridge University Press: 05 February 2014\nEndometriosis is an increasingly common gynaecological disorder, confined to women of a reproductive age and limited to Homo sapiens and the higher primates. It would appear that an erect posture, although providing advantages in evolutionary terms for defence, hunting and the acquisition of food, also has a disadvantage: under the influence of gravity, an erect posture allows viable endometrial cells that pass through the fallopian tubes during retrograde menstruation to implant in the deeper areas of the female pelvis.\nIt is a disease that affects a huge number of women throughout the world, and it has been estimated that between 1% and 15% of women who are examined for pelvic pain and infertility may have endometriosis. This is almost certainly an underestimate; the prevalence of the disease quoted in the medical literature ranges between 6% and 45%.\nThe main problem in trying to estimate the true prevalence of this disease is that the diagnosis can only be made with any accuracy by laparoscopic examination of the pelvis. This specialist procedure is only performed on patients who are referred by their general practitioners (GPs) with dysmenorrhoea, dyspareunia, pelvic pain or infertility. However, a great proportion of women regards many of these symptoms as part of ‘a woman's lot in life’, and many GPs unfortunately react in a similar way, prescribing increasingly stronger painkillers and multiple courses of antibiotics, in the often mistaken belief that pelvic inflammatory disease is the underlying problem. Thus, the time from the first consultation with typical symptoms to the actual establishment of the diagnosis is of the order of seven years.\n- Type\n- Chapter\n- Information\n- Endometriosis , pp. v - viPublisher: Cambridge University PressPrint publication year: 2004\nAccessibility compliance for the PDF of this chapter is currently unknown\nand may be updated in the future.\nTo save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.\nNote you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.\nFind out more about the Kindle Personal Document Service.\n- Introduction\n- Book: Endometriosis\n- Online publication: 05 February 2014\nTo save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.\n- Introduction\n- Book: Endometriosis\n- Online publication: 05 February 2014\nTo save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.\n- Introduction\n- Book: Endometriosis\n- Online publication: 05 February 2014","source_license":"CC0","license_restricted":false}