Division of Obstetrics and Gynecology, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy.
Gynecol Endocrinol. 2009 Nov;25(11):734-40. doi: 10.3109/09513590903159664.
Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induced a chronic inflammatory reaction. The data collected from Italy showed that around 3 million women are affected by endoemtriosis and the condition was predominantly found in women of reproductive age (50% of women were in the 29-39 age range), only 25% of women were asymptomatic. The associated symptoms can create an impact in general physical, mental, and social well-being. Endometriosis is associated with severe dysmenorrhea, deep dyspareunia, chronic pelvic pain, ovulation pain, cyclical, or perimenstrual symptoms, with or without abnormal bleeding, infertility, and chronic fatigue. The annual cost for hospital admission can be estimated to be in a total around 54 million euros. The average time for right diagnosis is around 9 years still today and it follows a long and expensive diagnostic search. Therapies can be useful to relieve and sometimes solve the symptoms, encourage fertility, eliminate endometrial lesions, and restore the anatomy of the pelvis. For medical therapy, several different preparations (oral contraceptives, progestogenics, gestrinone, danazol, and GnRHa) and new options (GnRH antagonists, aromatase inhibitors, estrogen receptor beta agoinist, progesterone receptor modulators, angiogenesis inhibitors, and COX-2 selective inhibitors) are available.
子宫内膜异位症定义为子宫内膜样组织出现在子宫外，引起慢性炎症反应。意大利的数据显示，大约有 300 万妇女受到子宫内膜异位症的影响，这种情况主要发生在育龄妇女（50%的妇女年龄在 29-39 岁之间），只有 25%的妇女无症状。相关症状会对整体生理、心理和社会健康产生影响。子宫内膜异位症与严重的痛经、深部性交痛、慢性盆腔痛、排卵痛、周期性或经前期症状、伴或不伴异常出血、不孕和慢性疲劳有关。住院治疗的年费用估计总计约 5400 万欧元。目前，正确诊断的平均时间仍约为 9 年，且诊断过程漫长且费用高昂。治疗方法可用于缓解症状，有时可解决症状，促进生育，消除子宫内膜病变，并恢复骨盆解剖结构。对于药物治疗，有多种不同的制剂（口服避孕药、孕激素、孕三烯酮、达那唑和 GnRH 激动剂）和新的选择（GnRH 拮抗剂、芳香化酶抑制剂、雌激素受体β激动剂、孕激素受体调节剂、血管生成抑制剂和 COX-2 选择性抑制剂）。
