Endometriosis

Endometriosis is a chronic gynecologic disease with a pleiotropic symptomatology, physical presentation, and treatment approaches. Ten percent of the population is affected; however, the prevalence in chronic pelvic pain or infertility-stricken women is much higher. Surgical diagnosis is adequate, but the classification scheme is of little value to clinicians. Apart from a genetic component to endometriosis, there are other predisposing factors that are predominately estrogen-driven. Several hypotheses exist, but there is no conclusive theory for either the pathophysiology of endometriosis or the mechanisms for attributed infertility and pain. This chapter describes approaches to treating infertility (both surgically and medically) as well as managing pain symptoms. As much as the literature provides, evidence-based studies have been summarized to maximize your treatment approaches to this vexing disease.