Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Endometriosis varies in symptoms and severity depending on the woman and the timing of the menstrual cycle.
Endometriosis may not produce any specific symptoms, and the women may not be aware of the condition. In fact, most women with endometriosis do not have any specific symptoms of the condition.
The most common symptom noted by women with endometriosis is pelvic pain that is worse just before menstruation, which then improves at the end of the menstrual period.
Other common symptoms are increased
pain during menstruation (dysmenorrhea),
pain with sexual intercourse (dyspareunia), and infertility.
Infertility is a common symptom of endometriosis; although not all women who have fertility problems have endometriosis. The exact mechanism by which endometriosis causes infertility is not clear; it may involve physical blocking of the
Fallopian tubes due to implants or scarring, or hormonal factors related to the presence of the endometriosis implants.
The age at which endometriosis develops varies considerably. Some adolescent women note painful menstruation when their periods first begin. This condition is later diagnosed as endometriosis, while other women are in their 20s, 30s, or older before endometriosis is diagnosed.
Women often describe the pain as a constant, aching pain that is deep and often spreads to both sides of the pelvic region, the lower back, abdomen, and buttocks.
There is no correlation between the severity of the symptoms and the amount of disease (the degree or extent to which endometriosis implants are present).
Many women with endometriosis have no findings on physical examination that
could suggest the diagnosis, and symptoms provide the only clues to the diagnosis.
Although physical examination findings cannot positively diagnose endometriosis,
the doctor may find pelvic nodules that are tender during a physical exam or masses in
the ovaries that are common signs of the condition.
An area of endometriosis on the ovary that has become enlarged is referred
to as endometrioma. When the center of this fills with blood, it is known as a chocolate cyst, referring to the appearance of the tissue. Chocolate cysts can become very painful, mimicking the symptoms of other ovarian problems.