Endometriosis

Endometriosis refers to the presence of endometrial like tissue outside the uterine cavity. It affects approximately 10% of women of reproductive age worldwide and is related to the presence of dysmenorrhea, pelvic pain and infertility, although the clinical manifestations are very varied. Multiple theories explain its pathophysiology: retrograde menstruation, celomic metaplasia, impaired immune response, vascular lymphatic metastasis, and oxidative stress are the main theories currently available. There are numerous endometriosis classification systems, but none are universal. The diagnosis of endometriosis is complex and it usually takes several years from the onset of symptoms to a confirmed diagnosis. The gold standard is direct detection of lesions by laparoscopy with removal and histological confirmation. Treatment can be both medical and surgical, the latter being reserved for cases refractory to medical treatment. Medical treatment consists of hormonal therapy with combined oral contraceptives or with only progestogens. GnRH agonists and aromatase inhibitors have also been used in some cases. In ad endometriosis, dysmenorrhea, pelvic pain; analgesia with acetaminophen and NSAIDs is recommended