What endometriosis is
Endometriosis is a long-term condition in which tissue similar to the lining of the uterus grows outside the uterus. It is most often found on the ovaries, the fallopian tubes and the lining of the pelvis. This tissue reacts to your monthly hormones. It can cause swelling, pain and, over time, scar tissue that makes organs stick together.
The condition is common. It is thought to affect roughly one in ten women of reproductive age. The exact cause is not known, and nothing you did caused it. There is no known cure at present, but treatment can control symptoms well for many women.
Common symptoms
Symptoms differ a lot from one woman to another. Some women have severe pain with a small amount of disease, and others have few symptoms even when the disease is widespread. You may notice:
- Period pain that stops you from going to work, college or daily tasks
- Pelvic pain that continues between periods
- Pain during or after sex
- Pain when passing urine or stools, mostly during periods
- Heavy periods
- Tiredness that does not improve with rest
- Difficulty getting pregnant
Many women are told that painful periods are normal. Mild cramps are common, but pain that disrupts your life deserves a proper check.
How doctors diagnose it
There is no single blood test for endometriosis. Diagnosis usually builds up in steps, and it can take time. A typical visit goes like this:
- The doctor asks about your periods, pain, bowel and bladder habits and plans for pregnancy.
- With your consent, a pelvic examination may be done to check for tender areas or lumps. You can ask for a female attendant to be present.
- An ultrasound scan of the pelvis looks for cysts on the ovaries called endometriomas, also known as chocolate cysts.
- An MRI scan is sometimes advised if deep disease is suspected.
- If the picture is still unclear, the doctor may suggest a laparoscopy, where a thin camera is passed through a small cut near the navel to look at the pelvis directly.
A normal scan does not rule out endometriosis, because small patches often do not show up. Many doctors start treatment based on symptoms alone and keep surgery for selected cases. It helps to keep a pain diary for two or three cycles and carry it to your appointment.
Treatment options
Treatment depends on your age, how severe your symptoms are, where the disease is and whether you want a pregnancy soon. Your doctor decides the plan with you, and it may change over the years.
Pain relief
Anti-inflammatory painkillers are often the first step. They work better when started as soon as the pain begins. Take them only as advised, as they do not suit people with certain stomach, kidney or asthma problems. A hot water bag and gentle exercise can ease cramps for some women.
Hormonal treatment
Hormonal medicines reduce or stop periods, which calms the endometriosis tissue. Options include combined contraceptive pills, progestogen tablets or injections, and a hormone-releasing intrauterine device. Stronger medicines that switch off the ovaries for a short time are kept for selected cases. These treatments control symptoms but do not remove the disease, and symptoms may return after stopping. Most of them also prevent pregnancy, so they are not suitable while you are trying to conceive.
Surgery
Surgery aims to remove or destroy the patches and cysts and to free stuck organs. It is usually done as laparoscopic surgery, also called keyhole surgery. Endometriosis can come back after an operation, so doctors often advise hormonal treatment afterwards. Removal of the uterus is considered only in severe cases when the family is complete and other options have not helped.
| Option | How it helps | Points to know |
|---|---|---|
| Painkillers | Reduce cramps and inflammation | Do not treat the disease itself |
| Hormonal medicines | Suppress periods and slow growth | Not for use while trying to conceive |
| Keyhole surgery | Removes patches, cysts and scar tissue | Disease may return later |
| Fertility treatment | Helps with conception | Does not treat the pain |
Endometriosis and fertility
Many women with endometriosis conceive naturally, especially when the disease is mild. Still, it can lower fertility by affecting the ovaries, the tubes or the pelvic environment. If you have been trying for a while without success, an infertility evaluation for you and your partner is a sensible next step. Depending on the findings, the doctor may suggest surgery, assisted methods such as IUI or IVF, or a mix of these. Large cysts on the ovary need careful planning, because surgery on the ovary can reduce the egg reserve.
Living with endometriosis
This is a long-term condition, so regular follow-up matters more than a single visit. Some things that women find useful:
- Regular physical activity such as walking, yoga or swimming
- Enough sleep and a balanced diet
- Tracking symptoms on a calendar or phone app
- Speaking openly with family or your partner about the pain
- Asking about counselling or pelvic physiotherapy if pain affects your mood or sex life
No diet or home remedy has been proven to clear endometriosis. Be careful with products that promise this. Costs of scans, medicines and surgery vary by city, hospital and case, so ask for a written estimate before you decide.
When to see a gynecologist
Book an appointment if you notice any of these warning signs:
- Period pain that is not controlled by simple painkillers
- Missing school, college or work every month because of pain
- Pain during sex or while passing stools
- Blood in urine or stools around your period
- No pregnancy after a year of trying, or after six months if you are over 35
Go to an emergency department if you have sudden severe pain in the lower abdomen, especially with fever, vomiting or fainting. This could be a twisted or burst cyst or another urgent problem.
This page is general information for readers in India. It is not medical advice. Speak to a qualified gynecologist about your own health.