Endometriosis is a prevalent condition where tissue similar to the lining inside the uterus, called the endometrium, starts to grow outside the uterus. This condition affects approximately 10% of women of reproductive age.


Clinical Features:

1. Chronic Pelvic Pain: Often cyclic, correlating with menstrual periods.
2. Dysmenorrhea: Painful menstrual periods that may begin several days before bleeding starts.
3. Deep Dyspareunia: Pain experienced during deep sexual intercourse.
4. Subfertility: Difficulty in conceiving, which is a common complication.
5. Non-Gynaecological Symptoms: These can include urinary issues like dysuria, urgency, haematuria, and bowel symptoms such as dyschezia (painful bowel movements).



i. Laparoscopy: This is the gold standard diagnostic tool for endometriosis, allowing direct visualization and possible biopsy of endometrial tissue outside the uterus.

Note: Hysteroscopy is not useful for diagnosing endometriosis as it only examines the inside of the uterine cavity, whereas endometrial tissue in endometriosis is found outside this area.


Initial Treatment:

NSAIDs and/or Paracetamol: These are the first-line treatments recommended for symptomatic relief.

Hormonal Treatments:
If pain relief is insufficient with NSAIDs or paracetamol, hormonal treatments are considered.

Combined Oral Contraceptive Pill (COCP): Often used to manage symptoms by regulating or stopping menstruation.

Progestogens: Examples include medroxyprogesterone acetate, which can help in reducing endometrial tissue growth and alleviating symptoms.

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