A systematic review on the prevalence of endometriosis in women

Abstract

Background & objectives: Endometriosis is one of the causes of female infertility, but the prevalence of endometriosis is not exactly known. We conducted a systematic review and meta-analysis to provide an estimate of the prevalence of endometriosis in women considering the stage of disease, diagnostic method, geographical distribution, clinical symptoms and sample size. Methods: MEDLINE, Web of Science, Google Scholar, Scopus and Cumulative Index of Nursing and Allied Health were searched to identify peer-reviewed studies published from January 1990 to December 2018 reporting the prevalence of endometriosis. Relevant additional articles were identified from the lists of the retrieved articles. Studies with cross-sectional design were included in the meta-analysis. Results: The overall prevalence of endometriosis was 18 per cent [95% confidence interval (CI): 16-20] and the prevalence of endometriosis by stage ranged from two per cent (95% CI: 1-4) for stage 4 to 20 per cent (95% CI: 11-28) for stage 1. The prevalence levels of endometriosis in women with infertility, chronic pelvic pain and asymptomatic were 31 (95% CI: 15-48), 42 (95% CI: 25-58) and 23 per cent (95% CI: 19-26), respectively. Interpretation & conclusions: The results of this study showed that the prevalence of endometriosis in developing countries was high. Future studies are needed to explore other factors affecting the prevalence of endometriosis worldwide, which may help develop future prevention programmes.

Fertility preservation in patients with endometriosis: Realistic approach or Future fantasy?

“…49 Similarly, this lack of direct correlation extends to its impact on fertility, as cases of stage four endometriosis with rectal involvement may not necessarily have a more profound effect on fertility compared to instances involving ovarian endometriomas, highlighting the intricate and multifaceted nature of the disease's influence on reproductive health. 50,51 Early evidence suggested that laparoscopic excision of any visible endometriotic lesions in early stages of the disease, seem to improve the fecundity of these women, however that does not justify aggressive surgical treatments. [52][53][54][55] Surgical management for endometriosis is usually reserved in cases of bilateral or large endometriomata, severe and/or recurrent disease and adhesions that might impact tubo-ovarian interface, or when the primary complaint is not related to fertility.…”

Patient and Practitioner: The Impact of Social Factors on Diagnostic Delay for Endometriosis

“…The exact prevalence of endometriosis is unknown, but approximations range from 1% to 10% [8,9]. Prevalence is much higher amongst women suffering from infertility and chronic pelvic pain, estimated to be 47% and 42%, respectively [10,11]. Unfortunately, until the accuracy of diagnostic measures improves and education among community members and HCPs increases, the exact prevalence of endometriosis will remain unknown.…”

Improving the diagnosis of endometriosis in Asia‐Pacific: Consensus from the Asia‐Pacific Endometriosis Expert Panel for Endometriosis

“…Dysmenorrhea is the cardinal complaint, present in approximately 50%-60% of women with endometriosis, followed by irregular and/or heavy menstrual bleeding (51%), non-menstrual chronic pelvic pain (CPP) (37%), deep dyspareunia (26%-55%), cyclical intestinal complaints (48%), cyclical urinary complaints (12%), and subfertility (12%-50%). [2][3][4][5] Globally, the prevalence of endometriosis is estimated to be 6%-10% among all women of reproductive age, 4,[6][7][8] more than 60% in women with CPP, 9 and around 30%-50% among women presenting with subfertility. 5,10 Epidemiological reports vary depending on data availability, study design and quality, diagnostic methods, accuracy of medical coding, geography, ethnicity, socioeconomic status, and other population distribution factors.…”

“…5,6,11 One large international meta-analysis of 17 studies that analyzed more than 127 000 women reported a pooled prevalence estimate of 18% among reproductiveage women, which appeared to be skewed upward by a higher prevalence among developing countries. 6 Relatively high rates of endometriosis have also been reported among women of Asian ethnicity compared with white female populations, 6,[12][13][14][15][16][17] which is noteworthy given that the Asian region comprises approximately 60% of the world's population, 18 approximately half of whom are women. 19 A recent meta-analysis reported a significant odds ratio of 1.63 for endometriosis diagnosis in Asian versus white women.…”