Drawing showing<unk>  Pain and infertility are common symptoms, although 20–25% of women are asymptomatic. Presence of pain symptoms are associated with the type of endometrial lesions as 50% of women with typical lesions, 10% of women with cystic ovarian lesions, and 5% of women with deep<unk>  do not have pain. Pelvic pain A major symptom of<unk>  is recurring pelvic pain. The pain can range from mild to severe cramping or stabbing pain that occurs on both sides of the pelvis, in the lower back and rectal area, and even down the legs. The amount of pain a person feels correlates weakly with the extent or stage (1 through 4) of<unk> , with some individuals having little or no pain despite having extensive<unk>  or<unk>  with scarring, while others may have severe pain even though they have only a few small areas of<unk> . The most severe pain is typically associated with menstruation. Pain can also start a week before a menstrual period, during and even a week after a menstrual period, or it can be constant. The pain can be debilitating and result in<unk> otional stress. Symptoms of<unk> -related pain may include: * dysmenorrhea (64%) – painful, sometimes disabling cramps during the menstrual period; pain may get worse over time (progressive pain), also lower back pains linked to the pelvis * chronic pelvic pain – typically accompanied by lower back pain or abdominal pain * dyspareunia – painful sexual intercourse * dysuria – urinary urgency, frequency, and sometimes painful voiding * mittelschmerz – pain associated with ovulation * bodily movement pain – present during exercise, standing, or walking Compared with patients with superficial<unk> , those with deep disease appear to be more likely to report shooting rectal pain and a sense of their insides being pulled down. Individual pain areas and pain intensity appear to be unrelated to the surgical diagnosis, and the area of pain unrelated to the area of<unk> . There are multiple causes of pain.<unk>  lesions react to hormonal stimulation and may "bleed" at the time of menstruation. The blood accumulates locally if it is not cleared shortly by the immune, circulatory, and lymphatic system. This may further lead to swelling, which triggers inflammation with the activation of cytokines, which results in pain. Another source of pain is the organ dislocation that arises from adhesion binding internal organs to each other. The ovaries, the uterus, the oviducts, the peritoneum, and the bladder can be bound together. Pain triggered in this way can last throughout the menstrual cycle, not just during menstrual periods. Also, endometriotic lesions can develop their own nerve supply, thereby creating a direct and two-way interaction between lesions and the central nervous system, potentially producing a variety of individual differences in pain that can, in some cases, become independent of the disease itself. Nerve fibres and blood vessels are thought to grow into<unk>  lesions by a process known as neuroangiogenesis. Infertility About a third of women with infertility have<unk> . Among those with<unk> , about 40% are infertile. The pathogenesis of infertility is dependent on the stage of disease: in early stage disease, it is hypothesised that this is secondary to an inflammatory response that impairs various aspects of conception, whereas in later stage disease distorted pelvic anatomy and adhesions contribute to impaired fertilisation. Other Other symptoms include diarrhea or constipation, chronic fatigue, nausea and vomiting, migraines, low-grade fevers, heavy (44%) and/or irregular periods (60%), and hypoglycemia. There is an association between<unk>  and certain types of cancers, notably some types of ovarian cancer, non-Hodgkin's lymphoma and brain cancer.<unk>  is unrelated to endometrial cancer. Rarely,<unk>  can cause endometrium-like tissue to be found in other parts of the body. Thoracic<unk>  occurs when endometrium-like tissue implants in the lungs or pleura. Manifestations of this include coughing up blood, a collapsed lung, or bleeding into the pleural space. Stress may be a cause or a consequence of<unk> . Complications Physical Health Complications of<unk>  include internal scarring, adhesions, pelvic cysts, chocolate cysts of ovaries, ruptured cysts, and bowel and ureter obstruction resulting from pelvic adhesions.<unk> -associated infertility can be related to scar formation and anatomical distortions due to the<unk> . Ovarian<unk>  may complicate pregnancy by decidualization, abscess and/or rupture. Thoracic<unk>  can be associated with recurrent thoracic<unk>  syndrome at times of a menstrual period that includes catamenial pneumothorax in 73% of women, catamenial hemothorax in 14%, catamenial hemoptysis in 7%, and pulmonary nodules in 6%. A 20-year study of 12,000 women with<unk>  found that individuals under 40 who are diagnosed with<unk>  are 3 times more likely to have heart problems than their healthy peers.<unk>  may increase about 1% or less chance of getting ovarian, breast and thyroid cancers in women compared with those without. It results in few deaths with unadjusted and age-standardized death rates of 0.1 and 0.0 per 100,000. Sciatic<unk>  also called catamenial or cyclical sciatica is a sciatica whose cause is<unk>  and whose incidence is unknown. Diagnosis is usually made by an MRI or CT-myelography. Mental Health<unk>  is associated with an elevated risk of developing depression and anxiety disorders". Studies suggest this is partially due to the pelvic pain experienced by<unk>  patients. "It has been demonstrated that pelvic pain has significant negative effects on women’s mental health and quality of life; in particular, women who suffer from pelvic pain report high levels of anxiety and depression, loss of working ability, limitations in social activities and a poor quality of life"
Endometriosis
Fibromyalgia
Pyometra
Interstitial cystitis
Endometritis
Pelvic inflammatory disease
Endometrioma
Irritable bowel syndrome