Endometriosis as very common cause of chronic pelvic pain – overview of actual knowledge
DOI:
https://doi.org/10.12775/JEHS.2023.46.01.026Keywords
endometriosis diagnosis, endometrosis therapy, dysmenorrhea, combined oral contraceptive, laparoscopyAbstract
Introduction and purpose of the study: Endometriosis is a prevalent condition that affects women in their reproductive years. Diagnosing the condition and determining its manifestations can be complex and uncertain, as they vary among individuals. The symptoms of endometriosis have a detrimental impact on the overall quality of life for patients, leading to decreased well-being, limitations in physical activity, and impaired social functioning. The available treatments for endometriosis are determined based on the primary symptom (chronic pelvic pain or infertility) and are primarily focused on surgical interventions, hormonal therapies, and analgesic medications. These treatments often come with numerous side effects and rarely offer long-term relief. In this review, we provide a comprehensive overview of the current knowledge regarding endometrosis, including its pathophysiology, diagnostic methods, and the existing treatment options.
Materials and methods: The analysis relied on examining materials obtained from both the "PubMed" database and books. The search was performed using the keywords: "endometrosis diagnosis", "endometrosis therapy", "dysmenorrhea", "combined oral contraceptive", "laparoscopy".
Summary: Endometriosis poses a significant health concern due to its correlation with compromised daily functioning and infertility. Appropriate diagnostic and therapeutic management of endometriosis contributes to a significant improvement in the wellbeing of patients, including a reduction in pain and improved ability to function both physically and socially. Conservative treatment consists of hormonal therapy, which regulates the menstrual cycle, reduces the severity of pain symptoms and inhibits the development of endometrial foci outside the uterus. In situations of advanced endometriosis, pharmacological treatments may not be sufficient and surgical therapy is required.
References
Zubrzycka A, Zubrzycki M, Perdas E, Zubrzycka M. Genetic, Epigenetic, and Steroidogenic Modulation Mechanisms in Endometriosis. J Clin Med. 2020 May 2;9(5):1309. doi: 10.3390/jcm9051309. PMID: 32370117; PMCID: PMC7291215.
Bulun SE, Yilmaz BD, Sison C, Miyazaki K, Bernardi L, Liu S, Kohlmeier A, Yin P, Milad M, Wei J. Endometriosis. Endocr Rev. 2019 Aug 1;40(4):1048-1079. doi: 10.1210/er.2018-00242. PMID: 30994890; PMCID: PMC6693056.
Hickey M, Ballard K, Farquhar C. Endometriosis. BMJ. 2014 Mar 19;348:g1752. doi: 10.1136/bmj.g1752. PMID: 24647161.
Mehedintu C, Plotogea MN, Ionescu S, Antonovici M. Endometriosis still a challenge. J Med Life. 2014 Sep 15;7(3):349-57. Epub 2014 Sep 25. PMID: 25408753; PMCID: PMC4233437.
Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010 Jun 24;362(25):2389-98. doi: 10.1056/NEJMcp1000274. PMID: 20573927; PMCID: PMC3108065.
Van Gorp T, Amant F, Neven P, Vergote I, Moerman P. Endometriosis and the development of malignant tumours of the pelvis. A review of literature. Best Pract Res Clin Obstet Gynaecol. 2004 Apr;18(2):349-71. doi: 10.1016/j.bpobgyn.2003.03.001. PMID: 15157647.
Giudice LC, Kao LC. Endometriosis. Lancet. 2004 Nov 13-19;364(9447):1789-99. doi: 10.1016/S0140-6736(04)17403-5. PMID: 15541453.
Indrielle-Kelly T, Frühauf F, Fanta M, Burgetova A, Lavu D, Dundr P, Cibula D, Fischerova D. Application of International Deep Endometriosis Analysis (IDEA) group consensus in preoperative ultrasound and magnetic resonance imaging of deep pelvic endometriosis. Ultrasound Obstet Gynecol. 2020 Jul;56(1):115-116. doi: 10.1002/uog.21960. PMID: 31876340.
Vassilopoulou L, Matalliotakis M, Zervou MI, Matalliotaki C, Krithinakis K, Matalliotakis I, Spandidos DA, Goulielmos GN. Defining the genetic profile of endometriosis. Exp Ther Med. 2019 May;17(5):3267-3281. doi: 10.3892/etm.2019.7346. Epub 2019 Mar 6. PMID: 30988702; PMCID: PMC6447774.
Grzegorz H. Bręborowicz. Położnictwo i Ginekologia. PZWL Wydawnictwo Lekarskie, wyd. 3, Warszawa 2020
International working group of AAGL, ESGE, ESHRE and WES; Tomassetti C, Johnson NP, Petrozza J, Abrao MS, Einarsson JI, Horne AW, Lee TTM, Missmer S, Vermeulen N, Zondervan KT, Grimbizis G, De Wilde RL. An International Terminology for Endometriosis, 2021. J Minim Invasive Gynecol. 2021 Nov;28(11):1849-1859. doi: 10.1016/j.jmig.2021.08.032. Epub 2021 Oct 21. PMID: 34690084.
Chapron C, Santulli P, de Ziegler D, Noel JC, Anaf V, Streuli I, Foulot H, Souza C, Borghese B. Ovarian endometrioma: severe pelvic pain is associated with deeply infiltrating endometriosis. Hum Reprod. 2012 Mar;27(3):702-11. doi: 10.1093/humrep/der462. Epub 2012 Jan 16. PMID: 22252082.
Sinaii N, Plumb K, Cotton L, Lambert A, Kennedy S, Zondervan K, Stratton P. Differences in characteristics among 1,000 women with endometriosis based on extent of disease. Fertil Steril. 2008 Mar;89(3):538-45. doi: 10.1016/j.fertnstert.2007.03.069. Epub 2007 May 11. PMID: 17498711; PMCID: PMC2939902.
Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, King K, Kvaskoff M, Nap A, Petersen K, Saridogan E, Tomassetti C, van Hanegem N, Vulliemoz N, Vermeulen N; ESHRE Endometriosis Guideline Group. ESHRE guideline: endometriosis. Hum Reprod Open. 2022 Feb 26;2022(2):hoac009. doi: 10.1093/hropen/hoac009. PMID: 35350465; PMCID: PMC8951218.
Hirata T, Koga K, Osuga Y. Extra-pelvic endometriosis: A review. Reprod Med Biol. 2020 Jul 16;19(4):323-333. doi: 10.1002/rmb2.12340. PMID: 33071634; PMCID: PMC7542014.
Sampson JA. Metastatic or Embolic Endometriosis, due to the Menstrual Dissemination of Endometrial Tissue into the Venous Circulation. Am J Pathol. 1927 Mar;3(2):93-110.43. PMID: 19969738; PMCID: PMC1931779.
Zondervan KT, Becker CM, Koga K, Missmer SA, Taylor RN, Viganò P. Endometriosis. Nat Rev Dis Primers. 2018 Jul 19;4(1):9. doi: 10.1038/s41572-018-0008-5. PMID: 30026507.
Ferguson BR, Bennington JL, Haber SL. Histochemistry of mucosubstances and histology of mixed müllerian pelvic lymph node glandular inclusions. Evidence for histogenesis by müllerian metaplasia of coelomic epithelium. Obstet Gynecol. 1969 May;33(5):617-25. PMID: 5778441.
Andres MP, Arcoverde FVL, Souza CCC, Fernandes LFC, Abrão MS, Kho RM. Extrapelvic Endometriosis: A Systematic Review. J Minim Invasive Gynecol. 2020 Feb;27(2):373-389. doi: 10.1016/j.jmig.2019.10.004. Epub 2019 Oct 13. PMID: 31618674.
Allaire C, Bedaiwy MA, Yong PJ. Diagnosis and management of endometriosis. CMAJ. 2023 Mar 14;195(10):E363-E371. doi: 10.1503/cmaj.220637. PMID: 36918177; PMCID: PMC10120420.
Seli E, Berkkanoglu M, Arici A. Pathogenesis of endometriosis. Obstet Gynecol Clin North Am. 2003 Mar;30(1):41-61. doi: 10.1016/s0889-8545(02)00052-9. PMID: 12699257.
Dunselman GA, Vermeulen N, Becker C, Calhaz-Jorge C, D'Hooghe T, De Bie B, Heikinheimo O, Horne AW, Kiesel L, Nap A, Prentice A, Saridogan E, Soriano D, Nelen W; European Society of Human Reproduction and Embryology. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014 Mar;29(3):400-12. doi: 10.1093/humrep/det457. Epub 2014 Jan 15. PMID: 24435778.
Nnoaham KE, Hummelshoj L, Webster P, d'Hooghe T, de Cicco Nardone F, de Cicco Nardone C, Jenkinson C, Kennedy SH, Zondervan KT; World Endometriosis Research Foundation Global Study of Women's Health consortium. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011 Aug;96(2):366-373.e8. doi: 10.1016/j.fertnstert.2011.05.090. Epub 2011 Jun 30. PMID: 21718982; PMCID: PMC3679489.
van der Linden PJ. Theories on the pathogenesis of endometriosis. Hum Reprod. 1996 Nov;11 Suppl 3:53-65. doi: 10.1093/humrep/11.suppl_3.53. PMID: 9147102.
Leyland N, Casper R, Laberge P, Singh SS; SOGC. Endometriosis: diagnosis and management. J Obstet Gynaecol Can. 2010 Jul;32(7 Suppl 2):S1-32. PMID: 21545757.
Guralp O, Kaya B, Tüten N, Kucur M, Malik E, Tüten A. Non-invasive diagnosis of endometriosis and moderate-severe endometriosis with serum CA125, endocan, YKL-40, and copeptin quadruple panel. J Obstet Gynaecol. 2021 Aug;41(6):927-932. doi: 10.1080/01443615.2020.1803245. Epub 2020 Oct 16. PMID: 33064040.
Guo C, Zhang C. Platelet-to-Lymphocyte Ratio and CA125 Level as a Combined Biomarker for Diagnosing Endometriosis and Predicting Pelvic Adhesion Severity. Front Oncol. 2022 Jun 21;12:896152. doi: 10.3389/fonc.2022.896152. PMID: 35800055; PMCID: PMC9255667.
Practice Committee of the American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertil Steril. 2014 Apr;101(4):927-35. doi: 10.1016/j.fertnstert.2014.02.012. Epub 2014 Mar 13. Erratum in: Fertil Steril. 2015 Aug;104(2):498. PMID: 24630080.
Saltiel E, Garabedian-Ruffalo SM. Pharmacologic management of endometriosis. Clin Pharm. 1991 Jul;10(7):518-31. PMID: 1830521.
Słopień R, Męczekalski B. Aromatase inhibitors in the treatment of endometriosis. Prz Menopauzalny. 2016 Mar;15(1):43-7. doi: 10.5114/pm.2016.58773. Epub 2016 Mar 29. PMID: 27095958; PMCID: PMC4828508.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Karolina Miszczyk, Malwina Gonet, Agata Kania, Michał Lazar, Patrycja Maj, Jakub Maternia, Piotr Mozer, Natalia Sergiel, Aleksandra Serwik-Trandasir, Karolina Włodarczyk-Cybulska
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 386
Number of citations: 0