Endometriosis is a condition where the tissue that lines the uterine cavity grows outside of the uterus, most commonly in the peritoneum, ovaries, fallopian tubes, behind the uterus, and on the surfaces of the uterus, bladder, rectum or intestines. This condition affects about 10% of reproductive-aged women. Some women with endometriosis have no to little symptoms, while others have severe pain and infertility. The most common symptom of endometriosis is chronic pain in the pelvis, usually right before or during the menstrual period. Women with endometriosis may also have urinary symptoms and pain with urination, or pain during bowel movements. Because of the inflammation and scarring associated with endometrioisis, there may be difficulty in getting pregnant. In fact, 40% of women with infertility have endometriosis. Physical examination, a patient’s history, and ultrasound or MRI may suggest endometriosis, but the only way to know for sure if there is endometriosis is to perform laparoscopic surgery. We routinely perform biopsies in this situation, and if extensive endometriosis is found, we remove all the implants and adhesions. Surgical treatment of endometriosis can help relieve or improve pain, and can restore fertility. Many times hormonal therapy, such as hormonal birth control or Lupron, is needed after surgery to further treat endometriosis and prevent or delay recurrence.