Rise and Rise of Endometriosis—An Enigma
Endometriosis, an estrogen-dependent condition causing chronic pain and infertility, affects 10% of reproductive-aged women globally and has distinct lesion phenotypes including superficial, ovarian, and deep infiltrating types.
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This editorial describes endometriosis as a chronic, estrogen-dependent, inflammatory gynecological condition, summarizing its prevalence, clinical phenotypes (superficial peritoneal, ovarian endometrioma, and deep infiltrating endometriosis), risk and protective factors, proposed theories of pathogenesis, and major symptom patterns. It emphasizes that diagnosis is often delayed due to non-specific symptoms and limited specificity of imaging and biomarkers, with definitive diagnosis stated to be via laparoscopy and histopathology, while noting major caveats such as MRI’s limited sensitivity for small superficial implants and the need for training for transrectal sonography. The paper also outlines approaches to evaluation using ultrasound (including the IDEA consensus components) and provides context on differential diagnoses, recurrence after therapy, and the relationship between endometriosis and infertility. This paper is centrally about endometriosis — it provides a high-level overview of epidemiology, pathogenesis, symptoms, diagnosis, and management concepts.
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