Studies

This publication combines a PRISMA-guided systematic review of the association between endometriosis and ovarian cancer risk with a multidisciplinary narrative review of the underlying molecular mechanisms, clinical implications, and prevention strategies. Endometriosis raises the relative risk of ovarian cancer, particularly clear-cell and endometrioid types, but that risk stays modest in absolute terms, staying under roughly 2 to 5% over a lifetime for most women. The authors are clear that this isn't a reason to start routine cancer screening or consider preventive ovary removal just because someone has endometriosis. Risk climbs somewhat higher in women with ovarian endometriomas or deep infiltrating disease, which is where individualized counseling matters most.

This state-of-the-art literature review explores the complex relationship between endometriosis and obesity, highlighting an inverse correlation between BMI and endometriosis prevalence. However, this association may be confounded by clinical and surgical challenges in obese patients, such as poor laparoscopic visualization and ventilatory compromise, which can artificially lower observed incidence rates. The review underscores the role of shared inflammatory pathways, including leptin, adiponectin, TNF-α, and IL-6, which contribute to the pathogenesis of both conditions. It also identifies GLP-1 and its analogues as a promising therapeutic avenue, given their potential to reduce pro-inflammatory secretions and macrophage infiltration. The authors call for human clinical trials to further investigate these mechanisms and their implications for treatment. Finally, the paper emphasizes the need for further research to clarify the biological interplay between endometriosis and adipose tissue, as well as the molecular effects of GLP-1.

Systematic review and meta-analysis (PRISMA, PROSPERO-registered) pooling 10 studies and 2,877 women to quantify how often chronic endometritis, a persistent and frequently underdiagnosed inflammation of the endometrium, coexists with adenomyosis. Chronic endometritis was present in a pooled 32% of women with adenomyosis, with prevalence varying sharply by how adenomyosis was diagnosed (MRI 64%, hysterectomy 21%, hysteroscopy 8%). Women with adenomyosis had a significantly higher risk of chronic endometritis than controls (OR 3.81, 95% CI 2.23-6.50). The authors conclude the two conditions frequently co-occur, sharing inflammatory and structural changes at the endometrial-myometrial interface that may impair reproductive outcomes.

Review synthesizing evidence on how disorders of gut-brain interaction affect women differently across the lifespan, including comorbid conditions like endometriosis. The authors call for clinical trials that account for hormonal influences on symptoms and treatment outcomes, inclusion of sex-specific comorbidities, and cross-disciplinary trial designs addressing overlapping symptoms between gut-brain disorders and gynecological conditions.

Bioinformatics study combining gene expression data from the Turku Endometriosis Database with Global Burden of Disease 2021 data. Identified upregulated genes (FOS, DES) and pain-related genes (NGF, BSN). Women with endometriosis showed the highest rates of total years lived with disability (19.98%), with anxiety contributing 17.21% and major depression 8.12%. The identified genetic markers related to pain provide a biological basis for the profound physical suffering, while the DALYs and YLDs data quantify the devastating impact on mental health - underscoring the importance of adopting a holistic, psychosomatic approach to managing endometriosis.

Women with endometriosis show significantly elevated risks for depression, anxiety disorders, and substance use disorders. Notably, postoperative hormonal therapy did not reduce psychiatric risk, highlighting the need for integrated gynecologic and psychological care.