Who Gets Endometriosis

Almost any female between puberty and menopause is susceptible to the onset of endometriosis. As younger girls in their mid-teens are being laparoscoped to investigate their period pain, we are finding an increased incidence of endometriosis in these young women.

Similarly, endometriosis has also been found in peri and post-menopausal women. However, endometriosis is relatively rare in this group.

It would seem that endometriosis is more likely to occur in females through their twenties and into their thirties. Women who delay their childbearing would seem to be more susceptible, although young women can still develop quite severe forms of endometriosis. Stress factors may play a part and contraceptive history may be important.

Pregnancy may disrupt the course of endometriosis, although not cure it in all patients. However, women who have had children are somewhat less likely to have endometriosis, although it is by no means rare in patients who have had perhaps one or two children.

Am I likely to have endometriosis?

Patients who are particularly likely to have endometriosis are those with the onset of increasing period pain where this has not been a particular problem in the past. Patients who are developing new pain on intercourse or vague, unexplained abdominal pain, which may be unrelated to either intercourse or periods, may also have endometriosis.

Endometriosis can sometimes be associated with period dysfunction and irregularity. Sometimes patients may present with symptoms of pain or pressure due to endometriotic cysts in the ovaries.

The classic association with endometriosis is, of course, infertility. Most patients with infertility are now laparoscoped, specifically to look for evidence of tubal damage and to check for endometriosis.

Gynaecologists need to be aware that the incidence of endometriosis is increasing as more patients defer their childbearing. Therefore, young women under the age of 40 who present with infertility or abnormal gynaecological symptoms, such as pain, bleeding, dyspareunia (pain on intercourse), or dysmenorrhoea need active investigation to exclude the possibility of developing endometriosis.