If anal cramping occurs during menstruation, the possibility of endometriosis must be ruled out. It is recommended that a gynecologic examination can be done, 3-7 days after menstruation, to find out if there are any visible nodules in the rectal trap of the uterus. If there are nodules and there is significant tenderness, it is likely to be a lesion of endometriosis. A vaginal ultrasound is recommended to find out the size of this ectopic lesion and to find out if there are other endometriosis lesions in the pelvis that can be treated surgically if necessary. However, the possibility of recurrence of ectopic lesions, even after surgery, is particularly high. It is recommended that post-operative treatment with Daphylline can be done for three to six months, mainly to prevent recurrence.