question: Hello doctor, I am a 32-year-old female. I had my second baby via c section. A couple of months after, I started getting pelvic pain. The pain is across my whole pelvic area and lower back and some times in my thighs too, very similar to menstrual cramps. Occasionally, I would get a sharp pain on either side of my pelvic area, especially on the right side. I also get pelvic cramps every time after sexual intercourse and occasional pain when I go to the toilet. The pain is bearable and when it gets a little worse I can manage it by taking pain killers. I get the pain almost every single day as well, not just when I am on my period. My periods have always been very heavy and painful from the beginning but have been able to keep it under control by taking the combined contraceptive pill Gedarel 30/150 mg and Mefenamic acid which I have been taking for many years. I have also been getting headaches and I am always very tired due to the lack of sleep I get from these pains during the night. Half the time I feel very stressed out because of the way I am feeling and it is not easy being a mom of two young children as well and having to manage with the pains, etc. I eventually visited the GP and had some tests done such as smear tests, infection swabs, blood tests and an ultrasound scan. Everything was normal but the transvaginal ultrasound showed I have endometriosis and adenomyosis. I was referred to a specialist gynecologist and although he has given me a course of action to follow for the next six months I felt that the appointment was a bit rushed and I had a lot of questions to ask regarding the two conditions. I would really like to ask a few questions regarding the conditions as soon as possible because my next appointment is not for another six months and there are a few things I would like to know about how these two conditions will affect me in the long run. I just need some answers for peace of mind. Nothing specific to me but more about the disease itself. The doctor has advised to take the combined contraceptive pill for another six months without a break and to take pain killers as and when required. The consultant also mentioned progesterone based methods but we had to rule that out as it causes hair loss and I have been through years of a form of alopecia and have just managed to get my hair back. I have tried asking doctors online and have been conned by them because they have taken money from me and just copied and pasted answers from other places online which made me quite upset and furious. Hopefully, someone from here can give me proper and professional answers. These are the following questions I would like to ask: What causes these two conditions? I am aware that these two conditions cannot be 100% diagnosed via imaging methods and laparoscopy is the only method that provides a definitive diagnosis, so how can a clinician be sure that they are treating me for the right condition and it is not something worse? How will these conditions affect me in the long run if they begin the progress? Which out of the two, endometriosis or adenomyosis is more severe and serious? How will they affect my fertility and what would happen if I wanted to have another baby in the future? Will it be hard to get pregnant? Will it cause problems to either me or the baby? Is there an increased risk of miscarriages and preterm labor and if so how likely is this? What if I were to come off the pill for whatever reason? How can I manage these conditions? Are there any other methods or a form of lifestyle I can follow to help such as certain dietary intakes, etc? How can I prevent getting pain when I go to the toilet (mainly passing stool) and help with sleep? Any other information will be greatly appreciated. Also, are there any online groups or support websites for these conditions?