Endometriosis—A disease because it is characterized by bleeding, ,

The hypothesis is advanced that endometriosis, an ovarian steroid hormone–dependent process, is physiologic unless recurrent bleeding in the ectopic implants causes progressive disease and symptoms. Diagnosis should take into account the detection of chronic bleeding, and efficient medical treatment can be achieved by amenorrhea without the induction of hypoestrogenism. (Am J Obstet Gynecol 1997;176:263-7.)