So endometriosis the primary presenting complaint is painful periods. Now the confusing thing is that painful periods can be just a normal part of a woman’s cycle. And that’s called dysmenorrhea, which is having cramping with your periods. But typically endometriosis is even more significant than that. And the only way to actually diagnose it for a certainty is by laparoscopy. It is a diagnosis based on the person’s history. But to be certain of the diagnosis, you have to have a laparoscopic evaluation. The reason why most of us as providers get flagged that you may have endometriosis because the painful periods are essentially debilitating. They really affect your quality of life, meaning you it’s hard to function to do regular daily activities. I mean, getting up out of bed just to go to work or to school. So because you have so much pain that makes us maybe think about endometriosis. A lot of times you have tried different remedies to see if the simple things improve, like anti-inflammatories such as ibuprofen and or birth control pills, which can or can not help with endometriosis.