•  Endometriosis is observed independent portion of , on the ovaries in anterior & posterior cul-de-sac & uterosacral ligament, posterior surface of broad ligament.
• Hormone treatment used to suppress endometriosis is contraceptive & dose not improve pregnancy rate
• With endometriosis, the tissue can be found on the ovaries, fallopian tubes or the intestines.
• The most common symptoms are pain and menstrual irregularities. 

Menstrual problems

What Are Menstrual Problems?

Menstrual cycles often bring about a variety of uncomfortable symptoms leading up to your period. Premenstrual syndrome (PMS) encompasses the most common issues, such as mild cramping and fatigue, but the symptoms usually go away when your period begins.

However, other, more serious menstrual problems may also occur. Menstruation that is too heavy or too light, or the complete absence of a cycle, may suggest that there are other issues that are contributing to an abnormal menstrual cycle.

Remember that a “normal” menstrual cycle means something different for every woman. A cycle that’s regular for you may be abnormal for someone else. It’s important to stay in tune with your body and to talk to your doctor if you notice any significant changes to your menstrual cycle.

Ovarian Cysts

Ovarian cysts are fluid-filled sacs or pockets in an ovary or on its surface. Women have two ovaries — each about the size and shape of an almond — on each side of the uterus. Eggs (ova), which develop and mature in the ovaries, are released in monthly cycles during the childbearing years.

Many women have ovarian cysts at some time. Most ovarian cysts present little or no discomfort and are harmless. The majority disappears without treatment within a few months.

Symptoms:

1. Pelvic pain — a dull or sharp ache in the lower abdomen on the side of the cyst
2. Fullness or heaviness in your abdomen
3. Bloating

Functional cysts

Your ovaries normally grow cyst-like structures called follicles each month. Follicles produce the hormones estrogen and progesterone and release an egg when you ovulate. If a normal monthly follicle keeps growing, it's known as a functional cyst.

There are two types of functional cysts:

• Follicular cyst. Around the midpoint of your menstrual cycle, an egg bursts out of its follicle and travels down the fallopian tube. A follicular cyst begins when the follicle doesn't rupture or release its egg, but continues to grow.
• Corpus luteum cyst. When a follicle releases its egg, it begins producing estrogen and progesterone for conception. This follicle is now called the corpus luteum. Sometimes, fluid accumulates inside the follicle, causing the corpus luteum to grow into a cyst.

Functional cysts are usually harmless, rarely cause pain, and often disappear on their own within two or three menstrual cycles.

• Endometriomas. These develop as a result of a condition in which uterine endometrial cells grow outside your uterus (endometriosis). Some of the tissue can attach to your ovary and form a growth.

Dermoid cysts and cystadenomas can become large, causing the ovary to move out of position. This increases the chance of painful twisting of your ovary, called ovarian torsion. Ovarian torsion may also result in decreasing or stopping blood flow to the ovary.

Risk factors

Your risk of developing an ovarian cyst is heightened by:

1. Hormonal problems. These include taking the fertility drug clomiphene (Clomid), which is used to cause you to ovulate.
2. Pregnancy. Sometimes, the cyst that forms when you ovulate stays on your ovary throughout your pregnancy.
3. Endometriosis. This condition causes uterine endometrial cells to grow outside your uterus. Some of the tissue can attach to your ovary and form a growth.
4.  A severe pelvic infection. If the infection spreads to the ovaries, it can cause cysts.
5. A previous ovarian cyst. If you've had one, you're likely to develop more.

Infrequent complications associated with ovarian cysts include:

• Ovarian torsion. Cysts that enlarge can cause the ovary to move, increasing the chance of painful twisting of your ovary (ovarian torsion). Symptoms can include an abrupt onset of severe pelvic pain, nausea and vomiting. Ovarian torsion can also decrease or stop blood flow to the ovaries.
• Rupture. A cyst that ruptures can cause severe pain and internal bleeding. The larger the cyst, the greater the risk of rupture. Vigorous activity that affects the pelvis, such as vaginal intercourse, also increases the risk.

Prevention

Although there's no way to prevent ovarian cysts, regular pelvic examinations help ensure that changes in your ovaries are diagnosed as early as possible. Be alert to changes in your monthly cycle, including unusual menstrual symptoms, especially ones that persist for more than a few cycles. Talk to your doctor about changes that concern you.

What Is a Pap Smear?

1. Pap smear screening is recommended starting around 21 years of age until the age of 65.
2. Guidelines on frequency vary from every three to five years.
3. If results are abnormal, and depending on the nature of the abnormality, the test may need to be repeated in six to twelve months.
4. If the abnormality requires closer scrutiny, the patient may be referred for detailed inspection of the cervix by colposcopy.
5. The person may also be referred for HPV DNA testing, which can serve as an adjunct to Pap testing
6. Additional biomarkers which may be applied as ancillary tests with the Pap test are evolving.
   

1. Starting sexual intercourse at an early age
2. Weakened immune system
3. Previous cancer of the lower genital tract

1. Menstrual: abnormal menstruation, absence of menstruation, heavy menstruation, irregular menstruation, short and light menstruation, or spotting
2. Weight: obesity, overweight, or weight gain
3. Skin: acne or oily skin
4. Also common: infertility, dark patches of skin in folds and creases, depression, inappropriate male features, loss of scalp hair, or unwanted hair