Endometriosis is a common condition in which the tissue that behaves like the cells lining the uterus (endometrium) grows in other areas of the body, causing pain, irregular bleeding, and possible infertility. Endometriosis is present in 10-15% of women, and is more common in relatives of patients with endometriosis. Often women have no symptoms or effects from endometriosis, but in some patients the symptoms can be debilitating.

Definitive diagnosis is made at surgery, but a physician may suspect the diagnosis by a patient’s history, physical exam, or ultrasound results. Sometimes patients are treated based on suspected endometriosis in order to avoid undergoing surgery.

Treatment of endometriosis depends on the symptoms present and the age/goals of the patient. For pain, patients may be treated with exercise, relaxation techniques, or non-steroidal anti-inflammatory drugs such as ibuprofen. Hormonal treatments such as oral contraceptives, progesterone pills, or injections may be used. In severe cases, a medication may be used which temporarily stops the ovaries from producing estrogen, placing the patient temporarily in a state of artificial menopause.

Laparoscopic treatment and/or hormonal therapy of endometriosis may improve fertility, in patients who are thought to be infertile because of endometriosis.

Surgery may be recommended for diagnosis and treatment of endometriosis. At surgery, visible endometriosis-related scar tissue may be removed or treated, but not all endometriosis may be visible. For example, endometriosis tissue may be present within the muscle tissue of the uterus, and not be visible at the time of abdominal surgery. In women with severe symptoms who have completed childbearing, hysterectomy with or without removal of the ovaries may be recommended as the best chance of cure.