To keep endometriosis under control, you have to look at this as a lifelong matter, and very often—most often—you go to a gynecologist, you have your endometriosis surgery and then you go back to your family doctor without any appropriate follow-up.
The follow-up should be some treatment, especially if there are symptoms. The treatment can be as simple as an intrauterine device, a Mirena. You don't get pregnant with this, but hopefully between pregnancies you are maintaining a milieu for the endometriosis that is suppressing estrogen. The same thing can be done with a low-dose birth control pill. These are both easily obtainable. If the endometriosis is more severe, then you have to bring out the bigger guns, and funding is a problem with that.
You need to have an understanding that endometriosis can rear its head anytime before menopause, so you need to follow that patient. You need, in this case, to do a pelvic examination, because that is the easiest. The pelvic examination includes a rectovaginal examination because that's where endometriosis flourishes, in nodules that cause pain.
There is a follow-up procedure to endometriosis, and unfortunately, in the countries that we mentioned, it is not perfect either because it is not a one-stop thing. It is something that goes on until your periods stop.