Introduction
Endometriosis, a common gynecological disorder in women of reproductive age, may arise from endometrial cells implanting in the pelvis due to retrograde menstruation under the influence of gravity in an erect posture.
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This chapter introduction reviews endometriosis as a reproductive-age, Homo sapiens (and higher primates) gynecological disorder thought to arise from retrograde menstruation under an erect posture that allows viable endometrial cells to implant deeper in the pelvis. It estimates prevalence as very variable, with published ranges from 1% to 15% among women examined for pelvic pain/infertility and 6% to 45% overall, while noting that these figures likely underestimate the true burden. The main stated limitation is diagnostic: accurate diagnosis requires laparoscopic pelvic examination, which is only performed after referral for specific symptoms, leading to a reported delay of about seven years due to symptom normalization and misattribution to pelvic inflammatory disease. This paper is centrally about endometriosis — it provides a background on prevalence, proposed pathogenesis, and the diagnostic delay stemming from reliance on laparoscopy.
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