View source for Endometriosis

==Background==
[[File:Figure 28 02 01.png|thumb|Normal female anatomy with uterus highlighted.]]
[[File:Uterine arterial vasculature.svg|thumb|Diagram of uterine blood supply.]]
*Endometrial glands and stroma at extrauterine sites, generally in the pelvis but can be anywhere in the body
*The condition is a common, benign, estrogen-dependent disorder
*Can be associated with debilitating symptoms

==Clinical Features==
*Classic symptoms: dysmenorrhea, [[pelvic pain]], dyspareunia, and infertility
*Mnemonic: 3 D's--dysmenorrhea, dyschezia and dyspareunia
*Other symptoms may include: include abnormal [[vaginal Bleed Non-Pregnant|uterine bleeding]], low [[back pain]], or chronic fatigue
*Endometriosis is commonly detected as an asymptomatic incidental finding on pelvic ultrasound or during a surgical procedure
*[[Catamenial pneumothorax]]- rare complication involving recurrent spontaneous pneumothoraces occurring around menses

==Differential Diagnosis==
*[[Ectopic pregnancy]]
*[[Pelvic inflammatory disease]]
*[[Interstitial cystitis]]
*[[Adenomyosis]]
*Ovarian neoplasms
*Pelvic adhesions
*[[Irritable bowel syndrome]]
*[[Colon cancer]]
*[[Diverticulitis|Diverticular disease]]
{{Pelvic pain DDX}}
{{VB DDX nonpregnant}}

==Evaluation==
*History of symptoms described above
*Exam with tenderness when palpating posterior fornix
*Labs are not generally useful
*[[Pelvic ultrasound]] is the first-line study
*Laparoscopy for definitive diagnosis

==Management==
*Symptomatic management
*[[Analgesia]]
*Hormonal medical therapy 
**OCP's, GnRH agonists, progestins, danazol, aromatase inhibitors
*Surgical intervention - conservative (retain uterus and ovaries) or definitive (TAH-BSO)

==Disposition==
*Discharge with OB/Gyn follow-up

==See Also==
*[[Pelvic Pain]]

==External Links==

==References==
<references/>

[[Category:OBGYN]]