What is endometriosis, and how is it treated?
Endometriosis is a common condition in which tissue similar to the lining of the womb grows outside it, usually in the pelvis. It often causes painful periods, pain during intercourse and sometimes difficulty conceiving. It is diagnosed through a conversation, an examination, an ultrasound and sometimes keyhole surgery, and it is managed with medicines, surgery or both.
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What is endometriosis?
Endometriosis is a common condition, and once you understand it, it becomes much easier to live with and to manage. It happens when tissue that is similar to the lining of the uterus starts to grow in places outside the uterus. It may settle on the ovaries, near the fallopian tubes, or on other surfaces inside the pelvis.
Every month, this tissue responds to your hormones, just as the lining inside the uterus does. But it has no easy way to leave the body. Over time, this can cause inflammation, pain and scarring, and sometimes cysts on the ovary, which are called endometriomas or "chocolate cysts" because of the dark, old blood inside them.
What are the symptoms of endometriosis?
Every woman is different. You may notice many of these, or only one or two:
- Period pain that is heavier than your own usual, pain that may begin before the period starts and carry on through it.
- Pain during intercourse, often felt deep inside.
- A deep ache low in the abdomen at other times of the month.
- Heavy bleeding during periods.
- Tiredness.
- Discomfort passing urine or stool during the period.
- Difficulty conceiving. For some women, this is the very first sign.
One point surprises many women: the amount of pain does not always match the amount of endometriosis. Some women with a lot of pain have little visible disease, and some with more extensive disease have milder symptoms. Period pain that keeps you from work, college or daily life, or that is getting worse over time, is worth having checked rather than simply put up with.
How is endometriosis diagnosed?
It begins with a simple, unhurried conversation. We ask about your periods, your pain, your family history, and how all of this affects your daily life. Then comes a gentle examination, followed by an ultrasound scan, which can show endometriosis cysts on the ovaries and some other changes inside the pelvis.
Small patches of endometriosis on the lining of the pelvis may not show up on a scan, so a normal scan does not always rule it out. In some cases, keyhole surgery, called laparoscopy, is advised. A small camera is passed through a tiny cut near the navel, which lets the surgeon look directly inside, confirm what is happening, and sometimes treat it in the same sitting. Please do not be alarmed by the word surgery. It is a small, precise procedure, and we advise it only when it truly helps.
How is endometriosis treated?
There is more than one path, and the choice depends on your age, your symptoms and your plans for a family. It is a decision we make together.
Medicines
For many women, treatment begins with medicines. There are tablets that help settle the hormonal cycle and quieten the monthly stimulation of this tissue. There are medicines to ease pain, and medicines to control heavy bleeding. Each one is chosen for your situation, and we always explain what a medicine does before you begin it.
Keyhole surgery
For some women, keyhole surgery is the more suitable path. Through the same small camera, the areas of endometriosis and any cysts can be carefully treated or removed, while the healthy tissue around them is protected. The aim is always to relieve the pain and to look after the ovaries and the tubes, especially if you hope to have a child in the future. Read more about laparoscopic (keyhole) surgery.
Endometriosis has a close relative, adenomyosis, in which similar tissue grows into the muscle wall of the womb itself, and the two sometimes occur together; see our guide to adenomyosis and fertility. Heavy, painful periods can also come from uterine fibroids, which is one reason a proper assessment matters.
Can I get pregnant if I have endometriosis?
This is one of the most important questions women ask. Endometriosis can make it harder to conceive for some women. But please hear this clearly: many women with endometriosis do go on to have children. There are treatments that can help, and there are further steps in fertility care that can be offered when they are needed.
A typical picture (a composite of many women, not a real patient) is a woman who comes in with painful periods and some difficulty conceiving. Once the condition is properly understood and addressed, her journey can move forward. So please do not lose hope.
Living well with endometriosis
A few everyday things make a real difference over time:
- Move gently and regularly. Regular, gentle exercise often helps with the pain.
- Look after the basics. A balanced diet, good sleep and managing stress all help.
- Keep a simple symptom note. Write down when the pain starts, how strong it is and how it relates to your period, so that together we can see the pattern.
- Stay in touch with your doctor. Endometriosis is managed over the long term, and treatment can be adjusted as your life and plans change. You do not have to carry it alone.
Sudden, severe pain low in the abdomen, especially with fever, vomiting or fainting, is different: do not wait for an appointment, and go to the nearest hospital straight away.
Where treatment happens
This guide is by Dr Mayur Pai, MBBS, MS (Obstetrics & Gynaecology), a fertility and laparoscopy specialist. Pai Hospital in Goa has its own operating theatre, so your scans, any keyhole procedure and your stay are handled in one place, by one team. Free patient transport is available from across Goa and nearby areas.
Getting started
If you have any concerns, or you would simply like to understand your own situation better, message us on WhatsApp at +91 77989 73345. Your first online consultation is free (one session). Consultations at the hospital are by appointment; to book one, call +91 77989 73345, or +91 95459 20817, or +91 75582 52088. This article is for education only and is not personal medical advice; please consult your doctor about your own situation.
Your questions
Is endometriosis common?
Yes. Endometriosis is a common condition in women during their reproductive years. Once it is understood, it becomes much easier to live with and to manage, and there is more than one way to treat it.
Can an ultrasound diagnose endometriosis?
An ultrasound can show endometriosis cysts on the ovaries and some other changes in the pelvis, but small patches may not show on a scan. When the picture is unclear, keyhole surgery lets the surgeon look directly inside, confirm the diagnosis and often treat it in the same sitting.
Does endometriosis always need surgery?
No. Many women begin with medicines that settle the hormonal cycle, ease pain and control heavy bleeding. Keyhole surgery is considered depending on your age, your symptoms and your plans for a family, and the decision is made together.
Can I get pregnant if I have endometriosis?
Many women with endometriosis do go on to have children. It can make conceiving harder for some women, but there are treatments that help, and further steps in fertility care can be offered when they are needed.
What can I do myself to ease endometriosis pain?
Regular, gentle exercise often helps, along with a balanced diet, good sleep and managing stress. Keep a simple note of your symptoms so that you and your doctor can see the pattern, and stay in touch, because endometriosis is managed over the long term.
Or call +91 95459 20817 · +91 75582 52088 · 0832 251 3641
This page is for general education and is not personal medical advice. Treatment depends on your own examination and reports, so please speak to a doctor about your situation. We do not carry out or offer sex determination of any kind.