A Clinical Overview of Endometriosis

Adriane Strawn
In: Lynchburg Journal of Medical Science · 2025 · vol. 1(1) · doi:10.63932/3067-7106.1007 · W4411989411
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This review discusses the pathophysiology, clinical presentation, diagnostic evaluation, and management of endometriosis, a condition affecting 10% of menstruating women characterized by endometrial tissue outside the uterus.

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This paper is a clinical review that outlines current understanding of endometriosis, including its proposed pathophysiology (e.g., retrograde menstruation, vascular/lymphatic spread, and coelomic metaplasia), typical and sometimes asymptomatic presentations, and the diagnostic role of imaging versus histologic confirmation from laparoscopic biopsies. It describes that endometriosis affects roughly 10% of menstruating women worldwide and is commonly associated with dysmenorrhea, infertility, and pelvic pain. The review emphasizes that management should be individualized and multimodal, ranging from analgesics and hormonal or non-hormonal medications to laparoscopic surgery and, in some cases, hysterectomy, while noting that diagnosis remains challenging. This paper is centrally about endometriosis — it provides an overview of proposed mechanisms, symptoms, diagnostic evaluation, and management strategies.

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Abstract

Endometriosis, the finding of endometrial tissue in areas of the body other than the interior of the uterus, affects about 10% of menstruating women worldwide and is a common reason for dysmenorrhea and infertility. The underlying pathophysiology is not fully known but thought to be mostly due to retrograde menstruation through the oviducts into the abdominopelvic cavity. Other major pathogenic theories include vascular and lymphatic spread and coelomic metaplasia. Patient symptoms may include dysmenorrhea, dyschezia, dyspareunia, pelvic pain, infertility, and fatigue, but patients can also be asymptomatic. Endometriosis is difficult to diagnose, and although it is possible to visualize certain endometriosis lesions with transvaginal ultrasound, magnetic resonance imaging, and computed tomography, the standard for diagnosis remains histological appearance from lesions biopsied during laparoscopy. Management of endometriosis should be individualized and involve a multimodal approach. Treatment may involve analgesics, hormonal medications, non-hormonal medications, lifestyle changes, laparoscopic surgery to remove lesions, or even hysterectomy. The purpose of this clinical review article is to give an overview of the proposed pathophysiology, clinical presentation, diagnostic evaluation, and management of endometriosis.
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Lynchburg Journal of Medical Science Specialty Women's Health Advisor Dr. Tom Colletti, DHSc, MPAS, PA-C Emeritus, DFAAPA; Dr. Blake Rogers, DMSc, PA-C Abstract Endometriosis, the finding of endometrial tissue in areas of the body other than the interior of the uterus, affects about 10% of menstruating women worldwide and is a common reason for dysmenorrhea and infertility. The underlying pathophysiology is not fully known but thought to be mostly due to retrograde menstruation through the oviducts into the abdominopelvic cavity. Other major pathogenic theories include vascular and lymphatic spread and coelomic metaplasia. Patient symptoms may include dysmenorrhea, dyschezia, dyspareunia, pelvic pain, infertility, and fatigue, but patients can also be asymptomatic. Endometriosis is difficult to diagnose, and although it is possible to visualize certain endometriosis lesions with transvaginal ultrasound, magnetic resonance imaging, and computed tomography, the standard for diagnosis remains histological appearance from lesions biopsied during laparoscopy. Management of endometriosis should be individualized and involve a multimodal approach. Treatment may involve analgesics, hormonal medications, non-hormonal medications, lifestyle changes, laparoscopic surgery to remove lesions, or even hysterectomy. The purpose of this clinical review article is to give an overview of the proposed pathophysiology, clinical presentation, diagnostic evaluation, and management of endometriosis. Recommended Citation Strawn, Adriane (2025) "A Clinical Overview of Endometriosis," Lynchburg Journal of Medical Science: Vol. 1: Iss. 1, Article 6. DOI: https://doi.org/10.63932/3067-7106.1007 Available at: https://digitalshowcase.lynchburg.edu/jms/vol1/iss1/6

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endometriosisdysmenorrheadyspareuniainfertility

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