Epidemiology

Endometriosis remains a disease marred with confusion due to the absence of an easy, noninvasive diagnosis; changing definitions; and the absence of a validated classification system. Endometriosis is one of the most common diagnoses in women with pelvic pain. Prevalence estimates vary from about a 4% occurrence of largely asymptomatic endometriosis found in women undergoing tubal ligation to 50% of teenagers with intractable dysmenorrhea. It is important to clearly distinguish among subtle, typical, cystic, and deep endometriosis and to understand the shifts that have occurred, mainly in the recognition of subtle endometriosis and deep endometriosis. Estimations of subtle endometriosis range from 5% to 50% and from 50% to 80% in asymptomatic or symptomatic women, respectively.