الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Endometriosis is defined as “a complex clinical syndrome characterized by an estrogen-dependent chronic inflammatory process that affects primarily pelvic tissues, including the ovaries”. It has a prevalence of 6%–10%, with peak age between 25 years and 35 years. However asymptomatic women can develop endometriosis lesions, and half of those who suffer from infertility are found to have them.
A plenty of theories have been proposed as explanations of the disease pathogenesis. These include: retrograde menstruation, benign metastasis, coelomic metaplasia, immune dysregulation, and endometrial stem cell theory. Age, family history, educational level, age at menarche, and exposure to endocrine-disrupting chemicals are risk factors known to be linked to endometriosis.Endometriosis patients are at higher risk to present with concomitant chronic pain diseases such as fibromyalgia, migraines, osteoarthritis, psoriatic arthritis, and rheumatoid arthritis. Irritable bowel syndrome is a common co-diagnosis. Adenomyosis and uterine fibroids are two non-malignant gynecologic conditions that are more common in endometriosis-affected women.
Painful periods (dysmenorrhea), chronic pelvic pain (cyclical and non-cyclical), painful sex (dyspareunia), and discomfort during defecation (dyschezia) and urination are among the painful symptoms frequently linked to endometriosis. The three most widely used classifications are the Endometriosis Fertility Index (EFI), the ENZIAN classification, and the revised American Society for Reproductive Medicine (rASRM) classification (stages I–IV; where stage I is equivalent to “minimal” disease and stage 4 to “severe” disease, according to the type, location, appearance, and depth of invasion of the lesions, and the extent of disease and adhesions.