CHARACTERISTICS OF HISTORY IN PATIENTS WITH ENDOMETRIOSIS
Abstract
Background. Endometriosis is an estrogen dependent disease that affects 5 − 20 % of women of reproductive age. Course of the disease is progressive and leads to a variety of symptoms that range from pain complaints to infertility. Some symptoms depend on the location of the break out. The most frequent symptoms are dysmenorrhea, dyspareunia, chronic pelvic pain and infertility. Endometriosis is also found in asymptomatic women. Clinical signs and symptoms with extrapelvic endometriosis are based on the involved organ system. Dysmenorhea may progress and begin prior to the onset of menses or become chronic and be noted throughout most of the menstrual cycle. Pain during menstrual cycle is estimated on 60–80 % of women with endometriosis. Dyspareunia is estimated on 25–50 % of women with endometriosis. It is frequently associated with rectovaginal and uterosacral ligament disease. It was established that advanced endometriosis is more frequently related to dysmenorrhea and deep dyspareunia in comparison with early disease. Chronic pelvic pain is defined as the pain that lasts 6 months and is not cyclic. In women being evaluated for pelvic pain, the diagnosis of endometriosis is made in 40–60 %, especially when it comes to deep infiltrative endometriosis. Infertility can be the only presenting symptom. The incidence of infertility in women with endometriosis is hard to establish. Some women with mild endometriosis are able to conceive, however this mild endometriosis can cause infertility. There is estimation that 20–30 % of women with endometriosis are infertile.
Conclusions. Medical history is very important in recognizing the disease. Endometriosis does not threaten life but is associated with significant morbidity of women. It has a major impact on women’s health and life quality and represents a significant public health issue. Because the clinical signs and symptoms are complex and there is sometimes lack of the association between the stage of the disease and intensivity of symptoms, the disease can be diagnosed too late.
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