Seminar

Endometriosis is a common, benign, oestrogen-dependent, chronic gynaecological disorder associated with pelvic pain and infertility. It is characterised by the presence of uterine endometrial tissue outside of the normal location—mainly on the pelvic peritoneum, but also on the ovaries and in the rectovaginal septum, and more rarely in the pericardium, pleura, and even the brain. The prevalence of pelvic endometriosis approaches 6–10 % in the general female population; in women with pain, infertility, or both, the frequency is 35–50%.1–3 The disorder is most commonly diagnosed in women of reproductive age, although times to diagnosis can be very long (mean 11·7 years in the USA and 8·0 years in the UK4) because of variability in symptoms and signs and confusion with other disorders. The gold standard for