Midwest Reproductive Center


Endometriosis is a chronic disease that affects about 6 million females in the U.S. It occurs when tissue that lines the uterus (the endometrium) is found outside the uterus — usually in the pelvis, on the ovaries, fallopian tubes, and ligaments that support the uterus; the area between the vagina and rectum; the outer surface of the uterus; and the lining of the pelvic cavity. Other sites for these endometrial implants may include the bladder, bowel, vagina, cervix, vulva, and in abdominal surgical scars. Less commonly they are found in the lung, arm, thigh, and other locations.

This misplaced tissue will respond to the menstrual cycle in the same way that the tissue of the uterine lining does: each month the tissue builds up, breaks down, and sheds. Menstrual blood flows from the uterus and out of the body through the vagina, but the blood and tissue shed from endometrial growths has no way of leaving the body. This results in internal bleeding, breakdown of the blood and tissue from the implants, and inflammation — which can cause pain, infertility, scar tissue formation, and bowel problems.

Signs of Endometriosis include:

  • Pain before and during periods
  • Pain with sex
  • Infertility
  • Fatigue
  • Painful urination during periods
  • Painful bowel movements during periods
  • Other Gastrointestinal upsets such as diarrhea, constipation, nausea.
  • 20% of women who have endometriosis may have no symptoms other than infertility

The diagnosis is made by visualization, usually by laparoscopy, a surgical procedure performed by Dr. Gehlbach in which he inserts a scope into your abdomen through an incision in your umbilicus. By this procedure he will be able to determine the location, size, and extent of the endometriosis, as well as any damage it may have caused. In most cases Dr. Gehlbach will also be able to remove all of the endometriosis present and repair the damage it has caused.

For More Information from ASRM on Endometriosis and Infertility