​Pathology - Endometriosis

​Pathology - Endometriosis 
The etiology is uncertain, but believed to result from a blend of genetic, hormonal, and immunological elements.
Affects 10% of women, typically aged 20 to 30.

Non-neoplastic nodules are abnormal growths of endometrial tissue found outside the uterus, commonly in the ovary, uterine ligaments, rectovaginal septum, and pelvic peritoneum. These nodules can lead to the formation of chocolate cysts on the ovaries due to cyclic bleeding of ectopic endometrial tissue.

Microscopic features include endometrial glands, endometrial stroma, and the presence of hemosiderin pigment.

Manifests as firm, detectable, ovarian masses on both sides, overall pelvic discomfort, painful menstruation (dysmenorrhea), and discomfort during sexual intercourse (dyspareunia); irregular menstrual cycles can result in infertility, which is the main concern for 30%-40% of individuals.

Therapy 
Options for treatment include oral contraceptives, medroxyprogesterone, danazol, GnRH analogues such as leuprolide, and surgical excision or coagulation of the lesion.
Adenomyosis is a condition where endometriosis occurs within the myometrium, often causing uterine enlargement and irregular bleeding.