CHRONIC GYNECOLOGICAL DISORDER – ENDOMETRIOSIS: EPIDEMIOLOGY, ETIOLOGY, AND MANAGEMENT

Abstract

Endometriosis is a chronic gynecological disorder characterized by the growth of endometrial tissue outside the uterine cavity. Ectopic endometrial implants exhibit cyclical bleeding during menstruation, which can lead to inflammation, fibrosis, and cyst formation. The disease is prevalent among women of reproductive age, affecting approximately 10–15% of women globally, and presents with symptoms such as dysmenorrhea, chronic lower abdominal pain, dyspareunia, and infertility.

The exact causes of endometriosis remain unclear; however, factors such as retrograde menstruation, genetic predisposition, immunological dysfunction, hormonal imbalances, environmental and lifestyle factors, and disruption of the pelvic microbiome play a significant role in its development.

Diagnosis involves clinical assessment, transvaginal ultrasonography, magnetic resonance imaging (MRI), and laparoscopy. Laparoscopy is considered the “gold standard” for diagnosis and allows histological confirmation. Laboratory biomarkers such as CA-125 provide additional supportive information.

Management is individualized and depends on the patient’s age, symptom severity, and reproductive plans. Pharmacological therapy includes hormonal treatments (progestins, GnRH analogs, aromatase inhibitors) and analgesics. Surgical approaches involve minimally invasive laparoscopic or robotic surgery, and in complex cases, assisted reproductive technologies such as in vitro fertilization (IVF) may be indicated. The primary goals of treatment are symptom relief, disease progression prevention, and preservation of reproductive health.

Endometriosis affects not only physiological but also psychological and social well-being. Early detection, individualized management, and preventive measures are essential to improve quality of life, halt disease progression, and maintain reproductive health.