Recurrence of endometriotic lesions is stimulated by estrogens, the female hormones produced by the ovaries. During the normal menstrual cycle, blood levels of estradiol (the main estrogen) fluctuate between 40 and 400 pg/mL. These levels are necessary to achieve pregnancy but they also contribute to the recurrence of endometriosis.
Recurrence rate for endometriosis has been estimated to be 10% per year. One study found it to recur in 40% of women within 5 years after conservative surgery. There is a 6 times higher risk of recurrence after hysterectomy if the ovaries are not removed. Even in women who have their ovaries removed, there is still a risk of further recurrence of Endometriosis.
On occasion endometrial adhesions can restrict the hip ligaments, causing pain and limping. Hip joint pain that worsens in a cyclical fashion in line with the menstrual cycle will usually be caused by endometriosis. Surgical treatment to remove endometrial implants is sometimes undertaken in the hope of relieving the hip joint pain associated with endometriosis.
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