Impact of Endometriosis on Women’s Health

A special issue of Endocrines (ISSN 2673-396X). This special issue belongs to the section "Female Reproductive System and Pregnancy Endocrinology".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 32600

Special Issue Editors


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Guest Editor
Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, 113-8655 Japan.
Interests: pathophysiology of the human reproduction and ovary; reproductive endocrinology; benign gynecological tumors; minimally invasive gynecological surgery and endoscopy; repair of pelvic floor; breast cancer; endometrial cancer
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Guest Editor
Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Japan
Interests: endometriosis; reproductive endocrinology; ovarian cancer; hypothalamic–pituitary–ovarian axis

Special Issue Information

Dear Colleagues,

Endometriosis is a disease that could affect women of reproductive age. It often manifests within the ovarian endometrioma, and the endometriotic lesions are mainly found in the pelvis, though extra pelvic lesions can appear. Endometriosis is considered to be an important disease that causes infertility and dysmenorrhea, and it has recently been noted that endometriosis significantly worsens quality of life (QOL) and adversely affects labor productivity. The pathophysiological cause of endometriosis is yet to be elucidated, but it has been suggested to be associated with the occurrence of dysmenorrhea during post-pubertal periods. In addition, there have been many reports in recent years that the occurrence of endometriosis is associated with pregnancy-related complications including threatened labor and placenta previa, osteoporosis, cancer, and mental disorders. In this Special Issue, we review the current knowledge of diseases associated with endometriosis and describe the future perspectives of clinical and experimental studies.

Prof. Dr. Osamu Hiraike
Prof. Dr. Akira Iwase
Guest Editors

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Keywords

  • endometriosis
  • ovarian reserve
  • endometrioma
  • infertility
  • preconception care
  • osteoporosis
  • cancer
  • dyslipidemia
  • menopausal transition
  • mental health
  • QOL
  • economic loss
  • complications during pregnancy

Published Papers (8 papers)

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Editorial

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2 pages, 183 KiB  
Editorial
Special Issue “Impact of Endometriosis on Women’s Health”
by Osamu Wada-Hiraike and Akira Iwase
Endocrines 2022, 3(2), 223-224; https://doi.org/10.3390/endocrines3020020 - 7 May 2022
Viewed by 2571
Abstract
Endometriosis is one of the most common diseases in women of reproductive age, and although there are many theories to explain this enigmatic disease, such as reflux theory, metastasis theory, and metaplasia theory, there is still no single theory that can wholly explain [...] Read more.
Endometriosis is one of the most common diseases in women of reproductive age, and although there are many theories to explain this enigmatic disease, such as reflux theory, metastasis theory, and metaplasia theory, there is still no single theory that can wholly explain the pathogenesis of the disease, and it is considered a mysterious disease until now [...] Full article
(This article belongs to the Special Issue Impact of Endometriosis on Women’s Health)

Research

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8 pages, 900 KiB  
Article
Impact of 1.0 mg/Day Dienogest Treatment on Bone Metabolism Markers in Young Women with Dysmenorrhea
by Ikuko Ota, Yoshiaki Ota and Fuminori Taniguchi
Endocrines 2021, 2(3), 293-300; https://doi.org/10.3390/endocrines2030027 - 26 Aug 2021
Cited by 3 | Viewed by 5054
Abstract
A low dose of dienogest (DNG) 1 mg/day is useful for treating dysmenorrhea in young women. However, the effect of DNG on bone turnover during bone growth and formation, rather than at maturity, is currently unknown even at low doses. We investigated change [...] Read more.
A low dose of dienogest (DNG) 1 mg/day is useful for treating dysmenorrhea in young women. However, the effect of DNG on bone turnover during bone growth and formation, rather than at maturity, is currently unknown even at low doses. We investigated change in bone turnover after 3 months of DNG 1 mg/day. This retrospective cohort study included young women aged 10–24 years with dysmenorrhea and irregular menstruation. Gonadotropins and the bone metabolism markers TRACP-5b and BAP were compared before and at 3 months after administration of DNG 1 mg/day. There were no significant changes in TRACP-5b (before, 455.6 ± 323.6 mU/dL; 3 months after, 462.1 ± 346.1 mU/dL), BAP (before, 24.7 ± 19.0 μg/L; 3 months after, 25.2 ± 22.3 μg/L), or the TRACP-5b/BAP ratio (before, 22.1 ± 7.0; 3 months after, 21.5 ± 6.3). Administration of DNG 1 mg/day had no significant effect on bone turnover after 3 months during the bone-growth phase in young women. Full article
(This article belongs to the Special Issue Impact of Endometriosis on Women’s Health)
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8 pages, 1429 KiB  
Communication
The Effects of Endometriosis on Ovarian Functions
by Michio Kitajima, Kanako Matsumoto, Itsuki Kajimura, Ayumi Harada, Noriko Miyashita, Asako Matsumura, Yuriko Kitajima and Kiyonori Miura
Endocrines 2021, 2(2), 142-149; https://doi.org/10.3390/endocrines2020014 - 3 Jun 2021
Cited by 5 | Viewed by 4091
Abstract
Infertility is a main manifestation of endometriosis, though the exact pathogenesis of endometriosis-associated infertility remains unclear. Compromised ovarian functions may be one of the causes of endometriosis related infertility. The ovarian function can be classified into three basic elements, (1) production of ovarian [...] Read more.
Infertility is a main manifestation of endometriosis, though the exact pathogenesis of endometriosis-associated infertility remains unclear. Compromised ovarian functions may be one of the causes of endometriosis related infertility. The ovarian function can be classified into three basic elements, (1) production of ovarian hormones, (2) maintenance of follicular development until ovulation, and (3) reservoir of dormant oocytes (ovarian reserve). The effects of endometriosis on ovarian hormone production and follicular development are inconclusive. Ovarian endometrioma is common phonotype of endometriosis. Development of endometrioma per se may affect ovarian reserve. Surgery for endometriomas further diminish ovarian reserve, especially women with bilateral involvement. Early intervention with surgery and/or medical treatment may be beneficial, though firm evidence is lacking. When surgery is chosen in women at reproductive age, specific techniques that spare ovarian function should be considered. Full article
(This article belongs to the Special Issue Impact of Endometriosis on Women’s Health)
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Review

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15 pages, 1034 KiB  
Review
Benefits of the Phytoestrogen Resveratrol for Perimenopausal Women
by Osamu Wada-Hiraike
Endocrines 2021, 2(4), 457-471; https://doi.org/10.3390/endocrines2040041 - 2 Nov 2021
Cited by 2 | Viewed by 4068
Abstract
Endometriosis, characterized by macroscopic lesions in the ovaries, is a serious problem for women who desire conception. Damage to the ovarian cortex is inevitable when lesions are removed via surgery, which finally decreases the ovarian reserve, thereby accelerating the transition to the menopausal [...] Read more.
Endometriosis, characterized by macroscopic lesions in the ovaries, is a serious problem for women who desire conception. Damage to the ovarian cortex is inevitable when lesions are removed via surgery, which finally decreases the ovarian reserve, thereby accelerating the transition to the menopausal state. Soon after cessation of ovarian function, in addition to climacteric symptoms, dyslipidemia and osteopenia are known to occur in women aged >50 years. Epidemiologically, there are sex-related differences in the frequencies of dyslipidemia, hypertension, and osteoporosis. Females are more susceptible to these diseases, prevention of which is important for healthy life expectancy. Dyslipidemia and hypertension are associated with the progression of arteriosclerosis, and arteriosclerotic changes in the large and middle blood vessels are one of the main causes of myocardial and cerebral infarctions. Osteoporosis is associated with aberrant fractures in the spine and hip, which may confine the patients to the bed for long durations. Bone resorption is accelerated by activated osteoclasts, and rapid bone remodeling reduces bone mineral density. Resveratrol, a plant-derived molecule that promotes the function and expression of the sirtuin, SIRT1, has been attracting attention, and many reports have shown that resveratrol might exert cardiovascular protective effects. Preclinical reports also indicate that it can prevent bone loss and endometriosis. In this review, I have described the possible protective effects of resveratrol against arteriosclerosis, osteoporosis, and endometriosis because of its wide-ranging functions, including anti-inflammatory and antioxidative stress functions. As ovarian function inevitably declines after 40 years, intake of resveratrol can be beneficial for women with endometriosis aged <40 years. Full article
(This article belongs to the Special Issue Impact of Endometriosis on Women’s Health)
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10 pages, 991 KiB  
Review
Clinical Aspects of Adolescent Endometriosis
by Tomoko Nakamura
Endocrines 2021, 2(3), 301-310; https://doi.org/10.3390/endocrines2030028 - 28 Aug 2021
Cited by 4 | Viewed by 6358
Abstract
Early diagnosis and long-term management of endometriosis is important in adolescent girls considering their potential for future pregnancy and need for preventing disease progression. However, symptoms and clinical findings of adolescent endometriosis may differ from those of typical adult endometriosis, making diagnosis difficult. [...] Read more.
Early diagnosis and long-term management of endometriosis is important in adolescent girls considering their potential for future pregnancy and need for preventing disease progression. However, symptoms and clinical findings of adolescent endometriosis may differ from those of typical adult endometriosis, making diagnosis difficult. In adolescents, menstrual pain may present as acyclic and unresponsive to commonly used medication. Typical imaging findings in adult endometriosis, such as ovarian endometriotic cysts and fibrotic scars, are less common in adolescents. Peritoneal lesions, characteristic of early-stage endometriosis, are commonly found in this age group. It should be noted that endometriosis may also be found in adolescents before menarche, because of premenarcheal endometriosis or congenital uterine anomaly and outflow obstruction; the latter requiring surgical correction. Although surgery is reported to be effective for pain, postsurgical recurrence rate is high, and the effect of hormonal treatment is controversial. The optimal timing for surgical intervention also remains to be determined. Here, we aim to identify the unique characteristics of endometriosis in adolescents to achieve early diagnosis and optimal management for this group of patients. Full article
(This article belongs to the Special Issue Impact of Endometriosis on Women’s Health)
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15 pages, 344 KiB  
Review
Malignancies Associated with Extraovarian Endometriosis: A Literature Review
by Naoki Inoue, Takashi Hirakawa, Junji Mitsushita, Yoshikazu Kitahara and Akira Iwase
Endocrines 2021, 2(3), 251-265; https://doi.org/10.3390/endocrines2030024 - 11 Aug 2021
Cited by 3 | Viewed by 2985
Abstract
Endometriosis-associated ovarian malignancies have been well documented. Although these malignancies also occur as extraovarian lesions, little is known about them. Thus, this literature review aimed to further explore these rarely experienced tumors. A total of 257 published cases between April 1990 and April [...] Read more.
Endometriosis-associated ovarian malignancies have been well documented. Although these malignancies also occur as extraovarian lesions, little is known about them. Thus, this literature review aimed to further explore these rarely experienced tumors. A total of 257 published cases between April 1990 and April 2020 were found using PubMed, and 212 cases were included in the analysis considering Sampson’s criteria and the history of endometriosis. We classified these cases as follows: intestine, abdominal scar, vagina and vulva, peritoneum and deep endometriosis, urinary tract, uterine cervix, and others. Age of patients, history of endometriosis, types of past hormonal therapy, symptoms, histological types, and treatment were identified. The most common tumor site was the intestine. Endometrioid carcinoma was the dominant histological type. Contrary to the ovary, clear cell carcinoma was rare in extraovarian sites. On the other hand, clear cell carcinoma represented the largest number of abdominal scars. This difference may help us to understand the development of endometriosis-related malignancies. Hormonal treatment was mentioned in 67 cases and estrogen replacement therapy in 33 cases. Although risks of estrogen therapy are still controversial, the highly differentiated histological types and hormone-dependent characteristics of endometriosis-associated malignancy should be considered. Physicians should be careful about estrogen monotherapy after hysterectomy and long-term hormone replacement therapy in patients with a history of endometriosis. Full article
(This article belongs to the Special Issue Impact of Endometriosis on Women’s Health)

Other

9 pages, 3321 KiB  
Case Report
A Case of Elastography-Assisted Laparoscopic Fertility Preservation for Severe Deep Endometriosis Causing Ureteral Stenosis and Subtype II Adenomyosis
by Yoshiaki Ota, Kuniaki Ota, Toshifumi Takahashi, Yumiko Morimoto, So-Ichiro Suzuki, Rikiya Sano, Ikuko Ota, Takuya Moriya and Mitsuru Shiota
Endocrines 2021, 2(3), 348-355; https://doi.org/10.3390/endocrines2030032 - 9 Sep 2021
Cited by 3 | Viewed by 2727
Abstract
Adenomyosis is commonly treated by total hysterectomy. Adenomyomectomy is considered for women of reproductive age who wish to preserve their fertility. However, a high recurrence rate following adenomyomectomy has been reported because complete removal of the lesion is difficult, and uterine rupture during [...] Read more.
Adenomyosis is commonly treated by total hysterectomy. Adenomyomectomy is considered for women of reproductive age who wish to preserve their fertility. However, a high recurrence rate following adenomyomectomy has been reported because complete removal of the lesion is difficult, and uterine rupture during pregnancy remains a complication. We previously reported that laparoscopic adenomyomectomy using a cold knife prevented thermal damage to the myometrium and elastography to avoid residual lesions. Here, we report the case of a patient who underwent complete resection of a subtype II adenomyosis and resection of deep endometriosis (DE) with the closure of the pouch of Douglas. The patient was 31 years old, had severe dysmenorrhea, and had left ureteral stenosis and subtype II adenomyosis associated with the closure of the pouch of Douglas by the DE. After resection of the DE posterior wall adenomyosis, residual lesions were confirmed by laparoscopic real-time elastography. Eight weeks after surgery, postoperative transvaginal ultrasound showed that the myometrium had shrunk from 28 to 22.7 mm, and the hydronephrosis had disappeared, although a stent remained necessary. In this study, we report the complete resection of subtype II adenomyosis and DE, combined with elastography to visualize the lesions during resection. Full article
(This article belongs to the Special Issue Impact of Endometriosis on Women’s Health)
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9 pages, 3705 KiB  
Case Report
A Feasible Technique in Laparoscopic Excision for Juvenile Cystic Adenomyosis: A Case Report, Literature Review, and Surgical Video
by Masafumi Katakura, Yukiko Katagiri, Kuniaki Ota, Takafumi Mukai, Kentaro Nakaoka, Toshimitsu Maemura and Mineto Morita
Endocrines 2021, 2(3), 284-292; https://doi.org/10.3390/endocrines2030026 - 23 Aug 2021
Cited by 1 | Viewed by 3506
Abstract
Background: Juvenile cystic adenomyosis (JCA) is a rare uterine lesion. We present the case of a young woman who was diagnosed with JCA and subsequently managed with laparoscopic cyst removal with sharp and blunt dissection. Moreover, we provide a literature review and a [...] Read more.
Background: Juvenile cystic adenomyosis (JCA) is a rare uterine lesion. We present the case of a young woman who was diagnosed with JCA and subsequently managed with laparoscopic cyst removal with sharp and blunt dissection. Moreover, we provide a literature review and a surgical video. Case: A 22-year-old nulliparous woman presented with severe dysmenorrhea and was assessed using contrast-enhanced abdominal computed tomography, transvaginal ultrasonography and pelvic magnetic resonance imaging, and diagnosed with a cystic lesion on the left side of the myometrium. She underwent laparoscopic cyst excision and uterine reconstruction. Histology was suggestive of JCA. The dysmenorrhea resolved postoperatively. Conclusion: Surgical resection is the first choice of treatment for cystic adenomyosis, and a laparoscopic approach using scissor forceps is effective. Full article
(This article belongs to the Special Issue Impact of Endometriosis on Women’s Health)
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