Endometriosis may also present with skin lesions in cutaneous endometriosis. Fibroids may also present alongside endometriosis, which itself may cause infertility. These tumors frequently co-occur with endometriosis or endometrial cancer. It may also be used for estrogen-dependent conditions such as endometriosis or uterine fibroids. Surgery is more effective than medicinal intervention for addressing infertility associated with endometriosis. Certain gynecological conditions are dependent on estrogen, such as endometriosis, leiomyomata uteri, and uterine bleeding. A major symptom of endometriosis is recurring pelvic pain. Menstrual discharge from the umbilicus is a rare disorder associated with umbilical endometriosis. One case report noted the development of endometriosis and adenomyosis in one menstrual cup user. Before that time, endometriosis and adenomyosis were considered together. The growths due to endometriosis are not cancer. She underwent surgery after being diagnosed with Stage IV endometriosis. The Institute conducts trials in menopausal issues, endometriosis, contraception, and more. In-vitro fertilization (IVF) procedures are effective in improving fertility in many women with endometriosis. Risk factors include a history of sexual assault, endometriosis, vaginitis, or a prior episiotomy.