DEAR DR. DONOHUE: I have some questions about endometriosis. I have seen three doctors who think I have a case of it.

One doctor put me on birth control pills, but they made me sick to my stomach. Another doc wants to check if my fallopian tubes are blocked. If so, I couldn’t have any more children.

Would I have a painful pregnancy if I did? Some days I get such awful pains that I have to lie down. Is it a good idea to try for more children? I have two now, the last one six years ago. – S.W.

ANSWER: The endometrium (IN-doe-ME-tree-um) is the covering layer of the uterus. Each month, during the menstrual period, the endometrium is shed.

Then the uterus begins forming a new covering in the event an egg is fertilized.

Sometimes pieces of endometrium get to places they shouldn’t be. They can pass through the fallopian tubes into the pelvis, where they implant on ligaments, ovaries, tubes or even the bowel or bladder.

Like the endometrium in the uterus, these transplants respond to the monthly surges of hormones. However, they cannot be shed like the uterine endometrium. They stay where they are and irritate structures they have landed on, causing pelvic pain, pain during intercourse and often infertility if they have narrowed the fallopian tubes.

The diagnosis of endometriosis can be made with 100 percent certainty when the doctor introduces a scope into the pelvis and spots the displaced tissue.

For mild pain, anti-inflammatory medicines can bring control – Advil, Aleve and the like. For greater pain, birth control pills often put an end to it.

Medicines that reduce the production of estrogen are also quite effective. Names of some of those medicines are Zoladex, Synarel and Lupron. Surgery is another way to treat endometriosis.

Sometimes that can be accomplished with small incisions through which a scope and special instruments, like a laser, can be passed. The laser destroys the endometrial tissue.

Pregnancy just about always relieves endometrial pain.

The booklet on endometriosis delves into all aspects of this common condition. Readers can obtain a copy by writing: Dr. Donohue – No. 1105, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Would you comment on the tattoo craze? Tattoos are seen more frequently these days, and it’s hard to imagine that this is a healthy trend. Besides the possibility of infections, what are other undesirable effects? Can they be removed? – N.G.

ANSWER: Close to a quarter of people between the ages of 18 and 50 have at least one tattoo. Why? Self-expression, patriotism (flags), peer pressure, affiliation with certain groups, a testimonial of affection and rebellion are some reasons, and some people find them quite attractive. People have had themselves tattooed for thousands of years. Complications actually are rather rare.

Allergic reactions are possible, and they can take place up to 17 years after getting the tattoo. Disfiguring scars sometimes result. Yellow colors can incite a reaction from sunlight.

Tattoos can be removed. Small ones can be cut off. Larger ones can also be cut off, but removal has to take place in stages.

A laser can be used to erase tattoos. A series of treatments is necessary, and often a faint outline of the tattoo remains or a scar forms. Tattoo removal is expensive, something a prospective tattoee should consider.

DEAR DR. DONOHUE: Is it better to drink diet pop or regular pop? – B.

ANSWER: It’s OK to drink either if you do so in moderation – one or two cans a day.

Regular pop has a hefty supply of calories, around 150 for 12 ounces. You don’t get any other nutrients with those calories – no minerals, no vitamins, no fiber. Sugar in regular pop promotes tooth decay.

Diet pop has no sugar, so that’s something in its favor.

Caffeine in either form of pop puts women at risk for coming down with high blood pressure if they drink four or more cans a day.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com