[Endometriosis - new clinical guidelines for better and equal care in Sweden]

Endometriosis is a chronic, inflammatory and estrogen-dependent disease affecting about 10 % of the female  population in fertile ages. There is no cure for endometriosis. The main symptoms include severe menstrual pain, ovulation pain, dyspareunia, dysuria and painful bowel movements. Endometriosis is associated with infertility. Endometriosis affects every day life with pain and fatigue and a negative impact on education, career, social life and quality of life.  Endometriosis can emerge at the first menstruations and also continue to give symptoms after menopause. The symptoms can vary greatly between individuals and also during life. The pathofysiology is unknown but the most accepted theory is retrograde menstruation where endometrial cells implant into the peritoneum affecting different abdominal organs. The immune system fails to clear the endometrial cells which results in endometriotic lesions that might cause inflammation, pain and adhesions. The treatment includes hormone treatment, surgical treatment, pain medication, physiotherapy, counseling and sometimes multi-disciplinary pain rehabilitation. It is important to increase the knowledge of this common disease both among the public and health professionals since early treatment is of great importance to reduce the risk for chronic pain and severe effects on quality of life. We hope that the recently published clinical guidelines will result in better and more equal care for patients with endometriosis in Sweden.