….and Doctors do not know the reason why the pain persists)

Is it endometriosis ?

Endometriosis is a condition that can cause pain in the lower part of the woman’s Difficulty getting pregnant is common. 

The “endometrium” is the name for the inner lining of the uterus. If you have endometriosis, the cells and tissue normally found in the endometrium (inside the uterus), grow outside of the uterus. Doctors do not know why. But when this happens, inflammation occurs, causing increasing lower abdomen (pelvic) pain, especially during the menstrual cycle. 

What are the symptoms of endometriosis?

Some have no or minimal symptoms, especially during early disease. Some females can begin to have the pain during their teenage years.

• Lower abdomen (pelvic) pain before or during monthly periods.
• Some Between monthly periods
• During or after sex
• When urinating or having a bowel movement (often during monthly periods)
• Trouble getting pregnant
• Growths on the ovaries that a doctor may feel during an exam

All of these symptoms can also be caused by conditions that are not endometriosis. But if you have any of these symptoms, tell your doctor. 

Is there a test for endometriosis?

No. 

There is no specific test, which makes this disease very difficult to diagnose, especially early. Direct visualization with surgery is the only way to know for sure, though if a lesion is seen on the cervix, this may be biopsied and offer a clue to the reading for the pain, 

The only way to know for sure if you have endometriosis is for a doctor to do surgery and look for endometriosis tissue outside the uterus.

How is endometriosis treated?

Endometriosis can be treated in different ways. The right treatment for you will depend on your symptoms and on whether you want to be able to get pregnant in the future.

Doctors can use medicines to treat endometriosis. These include:

• Pain medicine – Doctors may suggest such as ibuprofen (sample brand names: Advil, Motrin). 
• Birth control medicines – Certain birth control medicines (combination hormones), can help reduce pain symptoms. Options include pills, skin patches, vaginal rings, Some people choose to have surgery to treat endometriosis: Examples: 
• Laparoscopy – The surgeon will make a small cut in the abdomen and use a flexible camera inside the body. The endometriosis tissue can be removed. (this is how diagnosis is made)
• Hysterectomy – If the other treatments don’t work well, the next suggestion will be to remove the uterus (Hysterectomy). Sometimes it is also necessary to remove the ovaries and fallopian tubes.

Summary:

I have consulted with many female patients after they visit the hospital emergency department (ED/ER) for lower stomach (pelvic) pain.  After having had expensive blood tests and CT scans or ultrasound exams, the patient is told to follow up with their regular doctor as no reason for the pain was found. A careful exam and discussion with a doctor who listens and understands you, may be able to finally diagnose and treat this challenging and often frustrating medical condition!