as if the uterine lining were shed during menstruation, flowing backward through the fallopian tubes into the abdominal cavity instead of with the normal menstrual flow. Endometriosis may run in families since it is more common in first-degree relatives of those with the disease. Risk factors are giving birth first over age 30, an abnormal uterus, and being Caucasian. It occurs in 10 to 15 percent of menstruating women ages 25 to 44. Teenagers have been found to have the disease and 25 to 50 percent of infertile women may have it, since it may block conception(Merck, Ch. 237).
When a woman presents unexplained infertility or typical symptoms, endometriosis is suspected. Physical examination may result in normal findings, pain, or a mass of tissue behind the uterus or near ovaries, however, diagnosis can only be made if patches of the tissue are actually seen. A laparoscope, inserted into the abdominal cavity allows for this viewing. When the disease is not recognizable through viewing, the diagnosis will require a biopsy performed usually during the endoscopy. Ultrasound scans, barium enams with x-ray, computed tomography, and magnetic resonance imaging are also used to show disease progression, but may not be useful for diagnosis. Blood tests detecting ma
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