Endometriosis Specialist in Loudoun County, VA

Endometriosis is a common misconception that monthly or daily menstrual pain is normal. If you have been given contraception pills as a way to help with menstrual pain or have been told to “deal with the pain”, scheduler your consultation with Dr. Ayoub today.

What is Endometriosis
Endometriosis is a condition where the lining of the uterus grows either outside of the uterine muscle or into the muscle, with the latter known as adenomyosis. Endometriosis can spread to other sites in your body including the peritoneum, which is the lining of the pelvis, and even the ovaries and fallopian tubes.

“Endometriosis affects more than 6 million women in the United States.” Says Dr. Ayoub, CEO and founder of Virginia Obstetrics & Gynecology.

Endometrial tissue acts as it is supposed to during your period – it grows, then breaks down and causes bleeding. Because the bleeding has no place to go, it becomes trapped in your pelvis. Ovarian cysts called endometriomas, may also form, and due to irritation of the surrounding tissues, adhesions and scar tissue may develop, causing organs to stick together. This is thought to be a cause of infertility.


  • Common signs and symptoms of endometriosis include:
  • Painful periods (dysmenorrhea). Pelvic pain and cramping usually begin several days before your period and may continue for a few days into it.
  • Pain with intercourse. This is usually described as pain with deep penetration. This is due to endometriosis growing in the pelvis and causing scar tissue.
  • Pain with bowel movements or urination. Constipation, diarrhea and/or painful bowel movements usually occur during menses. Bloating, nausea and fatigue during menses are also common.
  • Excessive bleeding. This can be either heavy bleeding during menses, known as menorrhagia, or bleeding between menses, known as menometrorrhagia. Adenomyosis, endometriosis in the uterine muscle, may contribute to these symptoms as well.
  • Endometriosis may be associated with infertility.
  • Low back pain during menses. This is a common complaint in women with endometriosis.

Endometriosis lesions are usually inversely associated to the severity of pain. Therefore, the severity of pain isn’t necessarily a reliable indication of the extent of disease. It is common to see women who don’t have much pain are the ones that have a “frozen pelvis” where everything is severely scarred.

Women with endometriosis commonly complain of pain from recurring ovarian cysts. Ovarian cysts are rarely the cause of pain. However, ruptured ovarian cysts may cause pain but this is an exception for the cause rather than the norm.

Endometriosis is commonly mistaken for other disorders

Endometriosis can be mistaken for pelvic inflammatory disease (PID), ovarian cysts, or even irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. These may be blanket diagnoses, and the “real” diagnosis is endometriosis.

It is estimated that 8-10% of women have endometriosis. Due to the “writing off” of symptoms as normal menstruation for women, endometriosis is severely under-diagnosed.

Source: Mayo Clinic