Symptoms

Endometriosis often presents with an array of clinical symptoms, including non-cyclic pain, dysmenorrhea, dyspareunia, abnormal uterine bleeding, and infertility (Table 11.1). Nearly 15% of American women between the ages of 18 and 50 suffer from symptoms related to endometriosis.1 Although some of these symptoms are strongly suggestive of endometriosis, none is pathognomonic of the disorder and, conversely, can be present in 45-50% of asymptomatic women.2 Moreover, these symptoms are not exclusive and can be associated with other conditions, such as intra-abdominal adhesions, chronic pelvic inflammatory disease, ovarian cysts, adenomyosis, irritable bowel syndrome, or interstitial cystitis (Table 11.2). This chapter will focus on the symptoms, their pathophysiology, and their correlation to disease.