Melissa Steiner, a 19-year-old patient of Dr.Beck, was diagnosed with endometriosis when she was 17. She has had two laparotomy procedures and continues to complain of moderate to severe pain before and during menstruation. What can Betsy tell her about the disease to help her understand shy she has the pain? Melissa also wants to know about long-term complications, including the impact of the disease on fertility. She asks Betsy to help her understand Dr.Beck’s explanation of the disease. How should Betsy handle her request?

Endometriosis is a disease in which endometrial tissue appears outside the uterus, endometrial tissue is detached in each menstrual cycle and causes bleeding, if tissue appears in other places such as the abdominal cavity, with each menstruation these areas bleed and there is abdominal reactivity causing severe pain, if you had a laparotomy, the visible areas of the endometrium outside the uterus have probably been removed, but there is the possibility that there are very small areas that are not detected by the procedure and continue bleeding, so it may persist with pain and management with analgesic medications and oral contraceptives may be necessary, which show improvement in symptoms, however if you wish to become pregnant you should withdraw the medications even if the symptoms return, there is a relationship in which pelvic inflammation sustained by foci of endometriosis can decrease the ability to conceive, however it is not synonymous infertility and with follow-up can lead to successful pregnancies.