Endometriosis

Endometriosis is defined as the presence of endometrial-like tissue, glands and stroma, outside the uterine cavity. It is a benign estrogen-dependent chronic inflammatory disease that affects at least 10% of reproductive-age women. Endometriosis is often associated with a range of painful symptoms including chronic pelvic pain and dysmenorrhea. In common with other chronic pain conditions, women with endometriosis often report fatigue and depression. Infertility is significantly more common in patients with endometriosis, with a doubling of risk compared with women without endometriosis. Women with endometriosis also have a high risk of co-occurring or evolving multisite pain and of presenting with other non-malignant gynecologic and non-gynecologic diseases. There is often a long diagnostic delay after onset of symptoms. The availability of robust non-invasive biomarkers for diagnosis, prediction of response to treatment and monitoring of disease progression remain major unmet needs. The diagnosis of endometriosis should be based on patient interview, examination and imaging. As with other chronic inflammatory conditions, treatment should be viewed as a long-term process. The available medical treatments for symptomatic endometriosis work by inhibiting ovulation, lowering serum estradiol levels and suppressing uterine blood flow. The currently available first-line treatments are hormonal, such as progestins and low-dose oral contraceptives. Nowadays, surgery is considered a second-line treatment in most endometriosis patients. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

Taylor HS, et al. Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. Lancet. 2021;397:839–52. Horne AW, Missmer SA. Pathophysiology, diagnosis, and management of endometriosis. BMJ. 2022;379:e070750. Chapron C, et al. Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol. 2019;15:666–82. Shafrir AL, et al. Risk for and consequences of endometriosis: a critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;51:1–15. Clemenza S, et al. From pathogenesis to clinical practice: emerging medical treatments for endometriosis. Best Pract Res Clin Obstet Gynaecol. 2018;51:92–101. Vercellini P, et al. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014;10:261–75. Laganà AS, et al. The pathogenesis of endometriosis: molecular and cell biology insights. Int J Mol Sci. 2019;20:5615. McNamara HC, et al. Peripheral, central, and cross sensitization in endometriosis-associated pain and comorbid pain syndromes. Front Reprod Health. 2021;3:729642. Tomassetti C, D’Hooghe T. Endometriosis and infertility: insights into the causal link and management strategies. Best Pract Res Clin Obstet Gynaecol. 2018;51:25–33. Zondervan KT, et al. Endometriosis. N Engl J Med. 2020;382:1244–56. Coloma JL, et al. Prevalence of fibromyalgia among women with deep infiltrating endometriosis. Int J Gynaecol Obstet. 2019;146:157–63. Greenbaum H, et al. Evidence for an association between endometriosis, fibromyalgia, and autoimmune diseases. Am J Reprod Immunol. 2019;81:e13095. Zhang T, et al. The link between immunity, autoimmunity and endometriosis: a literature update. Autoimmun Rev. 2018;17:945–55. Rius M, et al. HE4 might be a more useful tumor biomarker to detect malignancy in patients with ovarian endometrioma when malignancy is suspected. J Int Med Res. 2021;49:3000605211047701. Coloma JL, et al. Serological autoimmune profile of systemic lupus erythematosus in deep and non-deep endometriosis patients. J Reprod Immunol. 2023;156:103827. Guerriero S, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol. 2016;48:318–32. Ros C, et al. Bowel preparation prior to transvaginal ultrasound improves detection of rectosigmoid deep infiltrating endometriosis and is well tolerated: prospective study of women with suspected endometriosis without surgical criteria. Ultrasound Obstet Gynecol. 2021;57:335–41. Vercellini P, et al. Medical treatment of endometriosis-related pain. Best Pract Res Clin Obstet Gynaecol. 2018;51:68–91. Buggio L, et al. Oral and depot progestin therapy for endometriosis: towards a personalized medicine. Expert Opin Pharmacother. 2017;18:1569–81. Bafort C, et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev. 2020;10:CD011031. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG About this chapter Cite this chapter Martínez-Zamora, M.A., Carmona, F. (2024). Endometriosis. In: Shoenfeld, Y., Cervera, R., Espinosa, G., Gershwin, M.E. (eds) Autoimmune Disease Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-031-69895-8_56 Download citation DOI: https://doi.org/10.1007/978-3-031-69895-8_56 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-031-69894-1 Online ISBN: 978-3-031-69895-8 eBook Packages: MedicineMedicine (R0)