[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-51699-en":3,"doc-seo-51699-105":29,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":13,"seo_description":14,"update_tm":27,"read_time":28},51699,1099513958607,"Jiven","https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399",7,"Healthcare","Endometriosis (Review Article)","Endometriosis is characterized by the presence of endometrium-like tissue outside the uterus and is commonly diagnosed through surgical visualization, ideally laparoscopy. Management typically combines surgical removal of lesions with hormonal medication, though side effects and variable efficacy are common. The condition affects about 10% of women of reproductive age, with wide prevalence estimates across symptomatic, infertile, and hospitalized populations, and carries substantial physical, mental, sexual, social, and economic burdens.","The new e ngla nd jou r na l of m e dicine  \nReview Article  \nDan L. Longo, M. D., Editor  \nEndometriosis  \nKrina T. Zondervan, D. Phil., Christian M. Becker, M. D., and Stacey A. Missmer, Sc. D.  \nFrom the Endometriosis Care and Research (CaRe) Centre, Nuffield Department of Women’s and Reproductive Health (K.T.Z. , C. M. B.), and Wellcome Centre for Human Genetics (K.T.Z.), University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom; the Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children’s Hospital and Harvard Medical School, Boston Center for Endometriosis, Boston Children’s Hospital and Brigham and Women’s Hospital, and the Department of Epidemiology, Harvard T. H. Chan School of Public Health—all in Boston (S.A. M.); and the Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids (S.A. M.). Address reprint requests to Dr. Zondervan at the Nuffield Department of Women’s and Reproductive Health, University of Oxford Women’s Centre, Level 3, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom, or at [krina.zondervan@whr.ox.ac. uk](krina.zondervan@whr.ox.ac. uk).  \nN EnglJ Med 2020;382:1244-56 .  \nDOI: 10.1056/NEJMra1810764  \nCopyright © 2020 Massachusetts Medical Society.  \nndometriosis is defined as the presence of endometrium-like  \nEtcsumpeloexutssiydemptte utermatic,usp.1atHhooweverbiolog,itc,hndednitultiionsysoesmicnontatencureompaof thses thdise  \norder (Fig. 1).2 Endometriosis is primarily diagnosed through surgical visualization—ideally, laparoscopy. Treatment consists of surgical removal of lesions and hormonal medication, often with side effects and variable efficacy. The 2008 U.S. health care costs for endometriosis were approximately $4,000 per affected woman, which is similar to the costs for other chronic conditions such as type 2 diabetes, Crohn’s disease, and rheumatoid arthritis.3 The costs of care to manage symptoms, including chronic pelvic pain, dysmenorrhea, deep dyspareunia, dysuria, dyschezia, fatigue, and infertility, are much greater, since these symptoms affect physical, mental, sexual, and social well-being, as well as productivity.4-6  \nDespite the substantial effect that endometriosis has on women, their families, and the economy, public and professional awareness of the disorder remains poor.3,7 Here, we discuss the epidemiology, pathophysiology, and pathogenesis of endometriosis, as well as diagnosis and treatment, with an emphasis on how understanding the genetic origins ofthe disease can inform development of better diagnostic and treatment options.  \nEpidemiology  \nPrevalence  \nEndometriosis is estimated to affect 10% of reproductive-age women,8 which extrapolates to approximately 190 million women worldwide, given the World Bank’s population estimates for 2017.9 The true prevalence of endometriosis is uncertain, however, because definitive diagnosis requires surgical visualization. Estimates vary widely among population samples and diagnostic approaches.10 The prevalence ranges from 2 to 11% among asymptomatic women, 5 to 50% among infertile women, and 5 to 21% among women hospitalized for pelvic pain.8 Among symptomatic adolescents, the prevalence of endometriosis ranges from 49% for those with chronic pelvic pain to 75% for those with pain that is unresponsive to medical treatment.8  \nKnowledge of population distributions, disease manifestations, and risk factors is limited to data for women in whom endometriosis is successfully diagnosed. The number and characteristics of undiagnosed cases are unknown. Once we have more definitive epidemiologic and clinical data (perhaps through the use of future, noninvasive diagnostics), we may learn that everything we currently believe about endometriosis, which is biased toward factors associated with access to care, may represent only a portion of the story.8  \n1244 n eng l j med 382;13 [nejm.org](nejm.org) March 26, 2020  \n","cbCaiijnLOHlVaAi","https://ap.wps.com/l/cbCaiijnLOHlVaAi","pdf",3618127,1,13,"English","en",105,"# Epidemiology\n## Prevalence\n# Presentation, Risk Factors, and Coexisting Conditions\n# Initiation and Development across the Life Course\n# Diagnosis and Treatment","[{\"question\":\"How is endometriosis primarily diagnosed?\",\"answer\":\"Endometriosis is primarily diagnosed through surgical visualization, ideally laparoscopy, which enables direct observation of lesions.\"},{\"question\":\"What does typical treatment for endometriosis involve?\",\"answer\":\"Treatment consists of surgical removal of endometriosis lesions and hormonal medication; side effects and variable efficacy are noted.\"},{\"question\":\"Why is the true prevalence of endometriosis uncertain?\",\"answer\":\"Definitive diagnosis requires surgical visualization, so estimates vary by population sample and diagnostic approach, and undiagnosed cases are unknown.\"}]",1783631341,33,{"code":4,"msg":30,"data":31},"ok",{"site_id":24,"language":23,"slug":32,"title":13,"keywords":33,"description":14,"schema_data":34,"social_meta":86,"head_meta":88,"extra_data":90,"updated_unix":27},"endometriosis-review-article","",{"@graph":35,"@context":85},[36,53,68],{"@type":37,"itemListElement":38},"BreadcrumbList",[39,43,47,50],{"item":40,"name":41,"@type":42,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":44,"name":45,"@type":42,"position":46},"https://docshare.wps.com/document/","Document",2,{"item":48,"name":12,"@type":42,"position":49},"https://docshare.wps.com/document/healthcare/",3,{"item":51,"name":13,"@type":42,"position":52},"https://docshare.wps.com/document/endometriosis-review-article/51699/",4,{"url":51,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":23,"description":14,"dateModified":61,"datePublished":62,"encodingFormat":60,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":40,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-07-14","2026-07-09",true,{"@type":65,"interactionType":66,"userInteractionCount":20},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71,77,81],{"name":72,"@type":73,"acceptedAnswer":74},"How is endometriosis primarily diagnosed?","Question",{"text":75,"@type":76},"Endometriosis is primarily diagnosed through surgical visualization, ideally laparoscopy, which enables direct observation of lesions.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"What does typical treatment for endometriosis involve?",{"text":80,"@type":76},"Treatment consists of surgical removal of endometriosis lesions and hormonal medication; side effects and variable efficacy are noted.",{"name":82,"@type":73,"acceptedAnswer":83},"Why is the true prevalence of endometriosis uncertain?",{"text":84,"@type":76},"Definitive diagnosis requires surgical visualization, so estimates vary by population sample and diagnostic approach, and undiagnosed cases are unknown.","https://schema.org",{"og:url":51,"og:type":87,"og:title":13,"og:site_name":58,"og:description":14},"article",{"robots":89,"canonical":51},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":92},[93,97,101,105,110,115,118,123,128,131,135],{"id":20,"doc_module":4,"doc_module_name":45,"category_name":94,"show_sort_weight":95,"slug":96},"Story & Novel",90,"story-novel",{"id":46,"doc_module":4,"doc_module_name":45,"category_name":98,"show_sort_weight":99,"slug":100},"Literature",80,"literature",{"id":52,"doc_module":4,"doc_module_name":45,"category_name":102,"show_sort_weight":103,"slug":104},"Exam",70,"exam",{"id":106,"doc_module":4,"doc_module_name":45,"category_name":107,"show_sort_weight":108,"slug":109},5,"Comic",60,"comic",{"id":111,"doc_module":4,"doc_module_name":45,"category_name":112,"show_sort_weight":113,"slug":114},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":45,"category_name":12,"show_sort_weight":116,"slug":117},40,"healthcare",{"id":119,"doc_module":4,"doc_module_name":45,"category_name":120,"show_sort_weight":121,"slug":122},8,"Research & Report",30,"research-report",{"id":124,"doc_module":4,"doc_module_name":45,"category_name":125,"show_sort_weight":126,"slug":127},9,"Religion & Spirituality",20,"religion-spirituality",{"id":126,"doc_module":4,"doc_module_name":45,"category_name":129,"show_sort_weight":126,"slug":130},"World Cup","world-cup",{"id":132,"doc_module":4,"doc_module_name":45,"category_name":133,"show_sort_weight":132,"slug":134},10,"Lifestyle","lifestyle",{"id":136,"doc_module":4,"doc_module_name":45,"category_name":137,"show_sort_weight":106,"slug":138},19,"General","general"]