INCIDENCE OF ENDOMETRIOSIS

The incidence of endometriosis appears to be increasing. Such increase is real, as well as apparent. The real increase is probably due to the current trend of postponing conception well into the fourth decade of life. The apparent increase is due to both the frequent and indicated use of diagnostic laparoscopy as well as the heightened awareness of this disease complex by gynecologists.
In 1949 Meigs found that 5 to 15% of patients undergoing pelvic operations had endometriosis. This incidence increased to 18% of all gynecologic laparotomies as reported in 1978. Presently, it is estimated that one third to one half of all patients undergoing major gynecologic procedures have findings of endometriosis.
From the early report of Meigs, it was noted that women who defer pregnancy to a later age and belong to higher socioeconomic groups were more frequently found in those who had endometriosis. Thus with increasing numbers of women working and pursuing careers and the accompanied deferment of pregnancies into the fourth decade of life, the incidence of endometriosis is likely to increase further.
Contrary to traditionally held views, endometriosis is more common in teenagers than hitherto believed. Endometriosis accounted for 65% and 47% of 43 and 140 symptomatic teenagers, respectively who underwent laparoscopy.
Endometriosis has also been frequently found in women who have undergone elective tubal sterilization. Endometriosis was found in 21 % of 54 women who had tubal ligation. In another study, endometriosis was found in 74% of women whose tubes were sterilized within 4 cm from the proximal end, but only 20% if the tubes were interrupted more than 4 cm from the proximal end. Although endometriosis generally regresses with the menopause, when cyclic ovarian activity ceases, postmenopausal endometriosis was found in 1.3% of 903 patients operated on for endometriosis.

There is a familial incidence of endometriosis with a 7% relative risk of developing it if a first degree female relative has it. The incidence of severe endometriosis in the familial group is higher (61.1%) than in the non familial group (23.8%).
Contrary to the former belief that endometriosis affects whites more often than blacks, it is now clear that black women are as frequently affected by endometriosis as their counterparts. therefore endometriosis should be considered in black patients who present with pelvic pain but do not fit the diagnosis of pelvic inflammatory disease.
Regardless of the origin of the disease, the lesion is more apt to occur and become clinically significant in women who have postponed childbearing, as prolonged cyclic ovarian function, uninterrupted by pregnancies, results in a continuous stimulus to proliferation and extension of the disease.
Women striken with endometriosis also experience a host of other complications as well; for example: irritable bowel syndrome, immune deficiency dysfunction, and perhaps most disheartening of all, primary and/or secondary infertility.
Endometriosis is one of the leading causes of infertility among women. This is one of the most poorly understood, misdiagnosed diseases today.

There is no known cure for endometriosis available at this time. There are only means of suppressing the disease for a limited time and ways of treating the pain associated with it.