Endometriosis occurs when endometrial tissue grows outside the uterus most commonly found implanted on the ovaries and tissues within the pelvis. It is a pathological entity requiring surgery to diagnosis and often treat. Endometriosis occurs in approximately 5 million women in the United States and the most often symptom is pain. Pelvic pain due to endometriosis lasts generally more than 6 months. Painful periods called dysmenorrhea, occur in up to 90% of women with this disease. Painful intercourse, deep pelvic pain, lower abdominal pain with or without back and side pain are also common. Pain with endometriosis can occur unpredictably and intermittently throughout the menstrual cycle or it can be continuous. The pain is often described as being dull, throbbing or sharp and may be exacerbated by physical activity. Hormonal therapy sometimes used to treat endometriosis may in some women worsen the pain.
The surgical diagnosis of endometriosis is often delayed due to the pain associated with this often debilitating disease may mimic other diseases. One in 5 women with endometriosis have concomitant pain conditions such as abnormalities of the uterus like adenomyosis and fibroids; of the fallopian tubes such as hydrosalpynx; of the ovaries associated with cysts; of the bladder as with interstitial cystitis; of the bowel due to irritable bowel syndrome; and of the musculoskeletal system as with piriformis syndrome. Women in doubt whether their pain is due to endometriosis or not should see their Gynecologist for diagnosis and treatment. If fertility is desired consultation with a board certified reproductive endocrinology and infertility specialist should be obtained.