01850nas a2200241   4500000000100000000000100001008004100002260001200043653001700055653001600072653002700088653001200115100002100127700001800148700002300166700001700189245004600206856005200252300001200304490000700316520127100323022001401594       2014                            d  c2014-0510aDrug therapy10ainfertility10aReproductive disorders10aSurgery1 aPaolo Vercellini1 aPaola Viganò1 aEdgardo Somigliana1 aLuigi Fedele00aEndometriosis: pathogenesis and treatment  uhttps://www.nature.com/articles/nrendo.2013.255  a261-2750 v103 aEndometriosis is characterized by the presence of ectopic endometrium causing pain, infertility or lesion progression; it affects ∼5% of women of reproductive age, with a prevalence peak between 25 years and 35 years of ageInteraction of the number and amount of menstrual flows with genetic and environmental factors seems to determine the likelihood of development as well as the phenotypic manifestation of the diseaseAlthough pain can be managed via pharmacological inhibition of ovulation and menstruation, lesions are not eradicated; surgery is generally associated with pain relief, but its benefit is often temporaryMedical therapy for infertility is inefficacious, whereas laparoscopic elimination of endometriotic lesions and adnexal adhesions increases the chances of conception moderately; in vitro fertilization is a valid alternative to surgeryEndometriosis is associated with a 50% increase in the risk of ovarian cancer; preventive interventions are possible, but screening of patients with endometriosis for ovarian cancer is presently not justifiedPrimary prevention of endometriosis is not currently feasible; treatment should be tailored to fit individual needs, and a shared decision-making approach between patient and clinician is encouraged  a1759-5037