Which clinical history is characteristic of endometriosis?

Updated: May 10, 2021
  • Author: G Willy Davila, MD; Chief Editor: Michel E Rivlin, MD  more...
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Common elements in the history include nulliparity and regular menstrual cycles with prolonged flow of 8 or more days. Onset of pain usually precedes flow by a few days and begins to resolve 1-2 days into the menses. Symptoms also usually improve during pregnancy and after menopause; they can recur postpartum or with postmenopausal hormone replacement therapy.

A familial/genetic predisposition has been documented. A woman with a first-degree relative with endometriosis has a lifetime risk of the disease approximately 10 times that of a woman without an affected family member.

When the products of cyclic sloughing of endometriotic implants become entrapped by cyst formation, the resulting mass is referred to as an endometrioma. These can occur in any location but are most commonly found involving one or both ovaries. These masses can become quite painful, and patients with rupture present with an acute surgical abdomen.

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