Among the more common problems that affect the female pelvic anatomy would be endometriosis and previous pelvic infection. Endometriosis affects 10-15% of all females. In this condition, the lining of the uterus, the endometrium, has begun to grow inside the pelvis. This leads to an inflammatory response, as the body tries to eliminate these misplaced cells. This disorder is a progressive problem, usually worsening with time. Initially, chemicals are produced that interfere with the interaction of egg and sperm. Then scar tissue or adhesions can develop and the pelvic structures begin to stick together. This can make it difficult for the fallopian tube to actually pick up the released egg. In its advanced form, the ovaries can develop blood-filled cysts term endometriomas that continue to get larger each month, causing a marked disruption in ovarian function. Some patients with endometriosis have pain. This pain can occur during intercourse or prior to the menstrual cycle or with bowel movements. There may be progressively worsening, significant menstrual cramps. Some patients, however, do not have pain from their endometriosis. Endometriosis often leads to infertility. The key to this disorder is to diagnose it early, before it has progressed to its more advanced stages, where the ultimate likelihood of pregnancy has diminished and the potential need for a hysterectomy has increased.

The diagnosis of endometriosis is suspected by the history of pain and by findings on the pelvic examination and ultrasound. However, the diagnosis is definitively made by laparoscopy. The purpose of this surgery is to both identify endometriosis and also treat it surgically at that same time. The treatment involves usually the use of a laser or other surgical modalities to vaporize away the endometriosis and the associated scar tissue. Although there are various medical therapies to suppress this disorder, the mainstay of treatment for endometriosis is surgery.

Unfortunately, endometriosis is a recurrent disease. The more advanced the initial case, the more likely there will be subsequent recurrence. This is why the diagnosis needs to be made as early as possible. IVF is sometimes required in order to achieve pregnancy when endometriosis is present.

Endometriosis As Described by the ACOG

Facts About Endometriosis