Endometriosis

Symptoms

• Increasingly painful periods
• Lower abdominal pain or pelvic cramps that can by felt for a week or two before menstruation
• Lower abdominal pain felt during menstruation (the pain and cramps may be steady and dull or quite severe)
• Pelvic or low back pain that may occur at any time during the menstrual cycle
• Pain during or following sexual intercourse
• Pain with bowel movements
• Premenstrual spotting
• Infertility

Note: Frequently, symptoms may not be present. In fact, some women with severe cases of endometriosis have no pain at all, while some women with only a few small implants have severe pain.

Exams and Tests

A pelvic examination may reveal the presence of tender nodules, with a lumpy consistency. These are often found in the posterior vaginal wall or adnexa (ovary regions), and they may sometimes be felt in healed wound scars (especially those from episiotomy and C-section). There may be pain with uterine motion.

The uterus may be fixed or retroverted. A pelvic ultrasound test may detect an endometrioma on an ovary. A laparoscopy is necessary for a definite diagnosis, but most patients can start treatment without this.

References

L Speroff, M Fitz. Clinical Gynecologic Endocrinology and Infertility. 7th ed. Lippincott Williams & Wilkins; 2004.

Hansen KA, Eyster KM. A review of current management of endometriosis in 2006: an evidence-based approach. S D Med. 2006 Apr;59(4):153-9.

Adamson GD, Pasta DJ. Surgical treatment of endometriosis-associated infertility: meta-analysis compared with survival analysis. Am J Obstet Gynecol. 1994 Dec;171(6):1488-504.