Endometriosis is characterised by
Endometriosis is an aberrant growth of endometrium outside the uterus, particularly in the dependent parts of the pelvis and in the ovaries and is the most common cause of secondary dysmenorrhea (see illustration). While retrograde menstruation is the most widely accepted cause, its pathogenesis and natural course are not fully understood. The overall prevalence in the United States is 6–10% and is fourfold to fivefold greater among infertile women.
Women with endometriosis will complain of pelvic pain, which may be associated with infertility, dyspareunia, or rectal pain with bleeding. Initially, pain tends to start 2–7 days before the onset of menses and becomes increasingly severe until flow slackens. With increasing duration of disease, pain may become continuous.

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