Endometriosis usually causes pelvic pain. This may include pain with menstrual periods, pain with intercourse, pain with urination or bowel movements, and generalized pelvic pain at other times in the cycle. Women with endometriosis have a higher risk of fertility problems and infertility may be the only symptom of this disease. Some women with endometriosis have normal fertility and no pelvic pain. Approximately one-third of infertility patients will have endometriosis.
Women undergoing laparoscopy for chronic pelvic pain have a high chance of having endometriosis.
Endometriosis can be suspected based on the patient's history, physical exam and ultrasound findings. The only way to make a definitive diagnosis, however, is to perform a laparoscopy. There is no reliable blood test for endometriosis. A pap smear will not detect endometriosis. The primary treatment of endometriosis is surgical at the time of a diagnostic laparoscopy.