Clinical Medicine Reviews in Women's Health

Endometriosis remains a cause of significant morbidity in reproductive-aged women resulting in pelvic pain, pelvic masses and infertility. Endometriosis is defined as the presence of endometrial glands and stroma outside of their normal intrauterine location, most commonly in the dependent portions of the pelvis. Endometriosis can be treated with medical therapies or surgery, both conservative and radical. The medical therapies include oral contraceptive pills, progestins, gonadotropin releasing hormone analogues and danazol. All of these medical therapies induce a hormonal steady state that results in an environment not conducive to the growth of endometriosis. Surgical therapies for endometriosis-associated pain include conservative treatments which include removal of endometriotic implants and adhesions with restoration of normal anatomy. Radical surgery involves removal of the uterus with or without removal of the ovaries in patients who have completed childbearing. Basic science discoveries about endometriosis hold the promise for less invasive diagnostic tests and improved therapies.