Endometriosis is a chronic, hormone-dependent, inflammatory disease, characterized by the presence and growth of endometrial tissue outside the uterine cavity and it is associated with chronic pelvic pain and infertility. Worldwide, approximately 176 million women between the ages of 15 and 49 are affected by endometriosis. Endometriosis is a complex disease that induces a chronic inflammatory process and can be challenging to treat. Chronic pelvic pain syndrome (CPPS) is defined as pelvic pain lasting greater than three to six months that is not solely related to menstruation, sexual activity or bowel movements.

Background: Leptin has been proposed as a biomarker for endometriosis. Previous studies have shown mixed results. The aim of this study was to compare peritoneal fluid (PF) leptin concentrations between patients with and without endometriosis in a cohort of sufficient size to detect a significant difference. Methods: Patients of reproductive age undergoing laparoscopic surgery for endometriosis or other benign indications in the Department of Gynecology, University of Bern between 2007 and 2018 were recruited.

Ovarian cancer affects 15 women per 100,000 in Europe [1] but it is not one disease. Epithelial malignancy the most common type of ovarian malignancy and defines the groups termed carcinoma [2,3]. Other malignant subtypes include sarcomas, germ cell tumors and sex-cord stromal tumors [1]. Ovarian carcinomas are subdivided based on histological features, the most common being high-grade serous carcinoma which makes up around 70% of ovarian carcinomas [2,4]. Up to 10% of ovarian carcinomas are endometrioid subtype, having phenotypic and molecular resemblances to endometroid adenocarcinomas that arise in the endometrial cavity [3,5] Clear cell carcinoma (OCCC) and endometrioid carcinoma of the ovary (EnOC) occur on a background of ovarian endometriosis in as many as 70% of cases [6,7]. OCCC is equally as common as endometroid type, perhaps reflecting this shared origin and collectively are often referred to as Endometriosis-Associated Ovarian Carcinomas (EAOCs). Mucinous carcinoma is less common than endometriosisrelated carcinomas at around 3% of ovarian carcinomas [2].

Pneumoperitoneum commonly occurs due to perforated viscus, yet a minority of cases can occur due to gynaecological causes, particularly following sexual activities. While not yet established, various hypotheses have been posited to explain the development of a spontaneous pneumoperitoneum after sexual intercourse. We herein present a unique case of a woman with a history of endometriosis and bilateral salpingectomy who presented with sudden abdominal pain that started after sexual activity.

Endometriosis is a disease with a poorly known etiology, characterized by the presence of dysfunctional endometrial tissue, which evolves to chronic inflammatory reactions in women of reproductive age, causing a great impact on the quality of life of this population, often leading to infertility. This article aims to describe the impact of endometriosis on women's health, as well as the complications it can cause.