"Ask Dr. Cook" is a series of questions and answers regarding endometriosis. The current subject and answer can be found on Current Ask Dr. Cook web page. The questions may represent a summary of questions I have been asked by several different patients. I hope you find this information helpful. If you have a question you would like answered, please Submit A Question.

Question:
Can endometriosis be confused with Pelvic Inflammatory Disease?

Answer:
Yes it is a possibility. Endometriosis and pelvic inflammatory disease can both cause pelvic pain. Pelvic inflammatory disease (PID) is a condition in which the fallopian tubes become infected, usually with chlamydia or a bacterial infection, including gonorrhea. There is no association between PID and endometriosis. While it is important to consider PID in the differential diagnosis of a patient with pelvic pain, all too often this is the assumed diagnosis in emergency rooms, especially in young single women. I would guess that a significant number of you with endometriosis have been told at one time or another that you have PID.

A person with PID usually experiences acute, (pain of short duration), not chronic pain. Often the patient has a fever, the WBC (white blood cell count) is elevated and a test called a sedimentation rate (also known as a ESR) is usually elevated. If not treated the patient can develop pus in the tubes (pyosalpinx), which can damage or even block the tubes resulting in a decrease in future fertility. The key to preventing tubal damage is early treatment with antibiotics. This is probably one reason the ER docs are so clued into PID in female pelvic pain patients.

Unlike the single short term pain usually seen with PID, women with endometriosis suffer from recurrent cyclic pain over a long period of time.

Updatede October 29, 2005