ENDOMETRIOSIS CAN CAUSE:
Pain
Irregular bleeding
Painful intercourse
Trouble becoming pregnant

Endometriosis tends to slowly worsen and cannot be reliably diagnosed by Physical Examination alone.  This condition does not reliably show up on ultrasound, CAT scan or MRI.  Surgical diagnosis (look inside abdomen with a scope instrument is generally required for confirmation).  Normally we diagnose endometriosis in the course of trying to manage pelvic pain.

WHAT CAUSES IT? Generally the cause is not known. There are several theories.
1. TUBAL REGURGITATION: During menses, some of the menstrual tissue backs up and passes through the fallopian tubes into the abdomen, where it attaches and grows.
2. GENETICALLY INHERITED: Endometriosis may be inherited genetically.
3. BLOOD OR LYMPHATIC SPREAD: Menstrual tissue may spread to other parts of the body through the lymphatic or blood vessels.
4. IMMUNE SYSTEM DEFECT: A defect in the immune system may allow the misplaced tissue to grow where it shouldn’t.

DIAGNOSIS: 
1. Medical History (questions) and Physical Examination.
2. Blood Tests, Cultures to rule out infection
3. Ultrasound for real-time pain mapping and to look at uterus, ovaries and pelvic structures.
4. Laparoscopy – a procedure performed under anesthesia that involves a 1/4 inch cut in your umbilicus, carbon dioxide gas is then used to fill the abdomen. Dr. Lackore inserts a scope instrument through the incision and looks inside for causes of pain. He is able to see the uterus, tubes, ovaries, and the surfaces where endometriosis may be. He will remove, excise or cauterize the endometriosis.
5. CAT Scan (computed tomography)
6. MRI (magnetic resonance imaging).

TREATMENTS
Non-habit forming pain relievers – Motrin, Aleve.
Birth control pills
Progestins / progesterone
GnRH agonists (Lupron/Orlissa) – menopausal side effects.  Short term use only.
Danazol – male hormone side effects, rarely used.
Surgery (conservative removal) – to preserve fertility.
Surgery (hysterectomy) – the Gold Standard for pain relief.

RECURRENCES:  Current treatments generally provide some relief from the pain but not a permanent cure. Endometriosis may return and even get worse after surgery or hormone therapy.  Other causes of pain must also be considered including Irritable Bowel Syndrome and Painful Bladder Syndrome.   Evaluation for these problems may provide you with further relief.

KEEP A RECORD OF YOUR PAIN AND BLEEDING: Go to iTunes or Google store and look for App:
Period Tracker Deluxe –  or
Period Tracker Pro (Pink Pad)  –  are my favorites.
Using one of these apps keep a record all symptoms and bring this with you to your appointment.  Include a list of activities you could NOT perform because of your symptoms (school, work, social activities).

VALUABLE ENDOMETRIOSIS LINKS:

www.endometriosis.org/

www.medicinenet.com/endometriosis/article.htm

www.endometriosisassn.org/