Doctor, I always have vague pain in my abdomen and anal swelling when I get my period every month, and I want to poop all the time, but when I go to the bathroom, it’s just some mucus-like stuff. Why do other people have menstrual cramps with stomach pains, but I always want to poop? If you have the same situation as described by this patient, or if you have bad pregnancy for no reason and all tests are normal, or if you have painful menstrual cramps, or even blood in your urine, hemoptysis, or blood in your stool during your period, it is time to come to the hospital to check if you have endometriosis. Most patients are confused when they first hear about this disease: What? Ectopic disease? What is that disease? So let’s first understand what the hell is endometriosis? 1. What is endometriosis? If we compare our body to a kingdom, then our organs are cities, each with its own guards to ensure the normal functioning of the city to maintain the stability of the kingdom. In the city of the uterus, our endometrial tissues are the guards, and these guards follow the command of the king’s brain and change month to month to maintain normal menstruation. But one day, for various reasons, these guards go the wrong way to another city, and then the kingdom will be in trouble! These guards do not know that they have gone astray and continue to listen to the brain’s command to complete their duty of forming menstruation. So in short, endometriosis is a series of problems caused by the lining of the uterus running away to a place that is not the uterus. These disobedient endometrium can grow in various organs of the body, such as the ovaries, fallopian tubes, intestines, abdominal wall, ureter, bladder, rectal fossa of the uterus, and in a few cases, in the lungs, perineum, subcutaneous, pleura, nasal cavity, etc. If they grow in the ovaries, they form chocolate cysts; if they grow in the myometrium, they form adenomyosis. The “lost” endometrium is pervasive and can appear in all parts of the body. 2. How is endometriosis diagnosed? The diagnosis of endometriosis relies on the patient’s symptoms, gynecological examination and relevant ancillary tests, while the histopathological findings are the basis for the diagnosis. For pelvic endometriosis, laparoscopy or open surgery is also the gold standard for diagnosis. Different sites of endometriosis have different concomitant symptoms. For example, if endometriosis occurs in the intestinal tract, patients will have digestive symptoms during menstruation, such as anal swelling, frequent stools, blood in stool, painful bowel movements or intestinal cramps; if endometriosis occurs in the urinary tract, symptoms of frequent urination, urgent urination, painful urination, blood in urination, and in severe cases, hydronephrosis and renal atrophy will occur; if endometriosis occurs in the lungs, symptoms of coughing up blood will occur during menstruation. 3.Treatment of endoheterosis! There are several treatments for endoheterosis as follows: ① drugs ② injections ③ drug stents ④ surgery ⑤ Chinese medicine treatment. Since endoheterosis is an estrogen-dependent disease, treatment to reduce estrogen in the body is effective. Injectable treatment is subcutaneous injection of GnRH-α needle, which works simply by reducing estrogen and shrinking the lesion while improving the symptoms. After the injection, the patient will experience temporary menopause, and after stopping the drug, menstruation will come, while the symptoms may reappear, because the disease is almost 100% recurrent without intervention. The difference between the drug stent treatment, i.e., the placement of the Manned Ring, and the ordinary birth control ring is that it is placed in the uterine cavity and continuously releases drugs into the uterus, which can act directly on the ectopic endometrium and shrink the ectopic endometrium’s. It is effective in severe dysmenorrhea caused by adenomyosis (endometrium into the myometrium) and is effective for up to 5 years. Surgery is the most fundamental and complete treatment, but due to the special nature of the uterus and ovaries for women, most patients cannot accept it. For patients with chocolate cysts when the cysts reach a certain level with indications for surgery, they mostly choose surgery to remove the cysts, for patients with adenomyosis they mostly perform focal excision of the lesions or total hysterectomy, for patients with endometriosis and pelvic endometriosis, they can choose electrocautery of the endometriosis For patients with intestinal endometriosis, part of the intestinal canal can be removed, and ovaries can be removed for symptomatic relief. Of course, depending on the condition, multiple treatments can be chosen simultaneously to maximize and optimize the effect of treatment. The choice of treatment depends on the severity of the patient’s condition, age, fertility requirements and other specific circumstances, and the doctor will develop an individualized treatment plan.