THE ENDOMETRIOSIS CYCLE AND ITS DERAILMENTS

Today's clinical challenge of endometriosis is to know when its presen ce can be called a disease and therefore to decide when treatment is i ndicated. The evolution of endometriosis is presented as a cycle which can derail. Local pelvic factors determine its different appearances and clinical symptoms. Microscopic and subtle lesions, as recently des cribed, can appear and disappear like mushrooms on the peritoneum (Fig ure 1), but progress in some patients to classical peritoneal lesions (Figure 2), typical chocolate cysts of the ovary (Figure 3) or nodular lesions of the pelvic supporting tissues (Figure 4).