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Adenomyosis and
Endometriosis
Chapter 25
Rahil Malik, MD
❍ What is the prevalence of endometriosis?
The prevalence of asymptomatic endometriosis is population dependent:
- 1% to 7% in women seeking elective sterilization.
- 12% to 32% among women of reproductive age with pelvic pain.
- 9% to 50% in infertile women.
- 50% among teens with chronic pelvic pain or dysmenorrhea.
The overall prevalence of endometriosis in reproductive-age woman probably is between 3% and 10%.
❍ The most common symptom of endometriosis is?
Dysmenorrhea and pain throughout the menstrual cycle. (25–67% of women with endometriosis.)
Dyspareunia is found in 25% and associated with uterosacral involvement.
Dyschezia.
❍ Other common symptoms and signs of endometriosis are?
Intraperitoneal bleeding, pelvic adhesions, pelvic pain, infertility, cyclic bowel and bladder symptoms, and
inflammation.
❍ What risk factors/associations have been implicated with development of endometriosis?
- Early menarche and short menstrual cycles—heavy consumption of alcohol and caffeine six to seven times more
prevalent among the first-degree relatives of affected women than in the general population.
Protective factors - Interestingly, the prevalence of endometriosis is inversely related to body mass index.
- Regular exercise and smoking may decrease the risk of endometriosis.
- Pregnancy has a protective effect that decreases with time; risk decreases with parity and prolonged periods of
lactation.
❍ What proportion of patients has uterosacral and cul-de-sac nodularity?
One-third of all patients with endometriosis.