Are these signs of endometriosis?

  Hi,
  I'm curious as to whether I should have my Dr check me for endometriosis. I'm 35 and have always had terrible menstrual cramps, including vomiting and diahrea. Ibuprofin is a lifesaver! A couple years ago I also started getting menstrual-like cramps that have me grabbing for the ibuprofin immediately after sexual relations, regardless of whether I reach orgasm and regardless of whether intercourse actually occurs -- it also happens with only external stimulation. The only time sex is comfortable for me is either a couple days before or a couple days after my menstrual period. If not endometriosis, do you have suggestions as to what else I might ask him to check for?
  Thanks,
  Deanne
Dear Deanne:
Endometriosis is associated with menstrual cramps and pain with intercourse. Pain with relations usually is worse around the days of menstrual flow and the pain ususally requires vaginal penetration.
Adenomyosis is sometimes called internal endometriosis. It is more common between the ages of 30 and 50 years in women who have had pregnancies. It is the normal endometrial lining that has grown into the muscle wall of the uterus. This would be a second condition to consider.
It is unclear if "pelvic congestion" is a real or "physician imagined" problem. The analogy is to varicose veins in the legs: when they are distended by standing, they cause discomfort. The analogy is that the veins in the pelvis are dilated during pregnancy and this weakens the walls so that later in life, these lax veins cause discomfort. It is worsened by sexual activity because arousal is associated with increased blood flow to the pelvic organs.
Finally, pelvic pain associated with sexual activity can be a response to unhappy sexual experiences.

Keywords: pelvic pain
This information is provided for education purposes and is not a medical consultation. If you have specific questions, please contact your physician.