Endometriosis (EMT) is a common and frequent disease in gynecology and is one of the most important causes of infertility in women of childbearing age, with an infertility rate of 40% in EMT patients and about 80% of infertility patients having EMT, of which 20% have moderate or above lesions. Therefore, it is important to diagnose EMT as early as possible for early treatment of infertile patients. For patients with secondary progressive dysmenorrhea, painful intercourse, menstrual disorders, etc., special attention should be paid to the relationship between the development and duration of pain or dysmenorrhea and menstruation and cesarean section, abortion, tubal lavage, etc. 1.1 Dysmenorrhea Dysmenorrhea is one of the main symptoms of EMT ( 70.2%), but it is not a necessary symptom of EMT EMT is mostly secondary dysmenorrhea, patients complain of no pain at the onset of menstruation, but dysmenorrhea starts to appear from a certain period, it can occur before menstruation during and after menstruation, some dysmenorrhea is so painful that bed rest or medication is needed to relieve the pain Pain often worsens with the menstrual cycle Except for ectopic endometrial bleeding that causes pain during menstruation. The local inflammatory process in pelvic EMT produces prostaglandin kinins and other peptides causing pain or tenderness. Currently, it is found that the presence of nerve factors in or around EMT lesions causes pain to occur But the degree of pain is often not proportional to the size of the lesion Clinically, the absence of dysmenorrhea accounts for about 25% of cases, so the presence or absence of dysmenorrhea is not the main basis for the diagnosis of EMT. 1.2 Menstrual disorders Some patients with EMT show various menstrual disorders such as increased menstrual flow and prolonged menstrual periods, which may be related to ovulatory disorders caused by abnormal ovarian function or to the coexistence of adenomyosis or fibroids. CPP is a common symptom of EMT. More than half of the patients with CPP suffer from EMT pain due to adhesions caused by recurrent small amount of bleeding in the ectopic lesion. 1.4 Others When endometriosis is implanted and growing in any part of the body, periodic painful bleeding or enlargement of masses may occur at the lesion site, such as abdominal scar endometriosis and perineal scar EMT intestinal EMT urinary EMT pulmonary EMT and brain EMT. 2, gynecological examination Special emphasis should be placed on the need for triple examination Typical EMT manifestation uterine posterior tilt fixed, rectal uterine sink uterosacral ligament or the lower part of the posterior wall of the uterus and other parts of the painful nodules can be found, more obvious during anal examination Ovarian endometriosis cysts, cystic masses are found in one or both adnexa, characterized by thick walls, often connected with the uterus fixed, and increase in size during menstruation, and shrink after menstruation if If the lesion involves the rectovaginal septum, an elevated purple-blue nodule may be detected or even seen in the posterior vaginal vault.