Endometriosis is a common but often misunderstood condition that affects millions of women. If you experience severe period pain or have been struggling to conceive, it could be a sign of endometriosis. This guide explains everything you need to know in simple terms.
What is Endometriosis?
Inside your uterus, there is a lining called the endometrium. This lining builds up each month to prepare for a potential pregnancy. If you don’t get pregnant, this tissue sheds – this is your menstrual period.
Endometriosis occurs when tissue similar to this uterine lining starts growing in other places. It can grow on your ovaries, fallopian tubes, the outside of your uterus, or other organs in your pelvis. This tissue behaves like the lining inside your uterus: it thickens, breaks down, and bleeds with each menstrual cycle. But because this blood and tissue have no way to leave your body, they become trapped. This leads to inflammation, scar tissue (adhesions), and very often, significant pain.
Types of Endometriosis
Doctors often classify endometriosis based on where it is located:
- Superficial Peritoneal Lesion: This is the most common type. The tissue implants on the peritoneum, a thin film that lines your pelvic cavity.
- Endometrioma (Chocolate Cysts): These are dark, fluid-filled cysts that form on the ovaries. They can be large and painful.
- Deep Infiltrating Endometriosis (DIE): This is a more severe form where the tissue grows deep under the peritoneal surface. It can affect organs near the uterus, like the bowels, bladder, or rectum.
Types of Endometriosis
Doctors often classify endometriosis based on where it is located:
- Superficial Peritoneal Lesion: This is the most common type. The tissue implants on the peritoneum, a thin film that lines your pelvic cavity.
- Endometrioma (Chocolate Cysts): These are dark, fluid-filled cysts that form on the ovaries. They can be large and painful.
- Deep Infiltrating Endometriosis (DIE): This is a more severe form where the tissue grows deep under the peritoneal surface. It can affect organs near the uterus, like the bowels, bladder, or rectum.
Symptoms of Endometriosis
The symptoms can vary greatly. Some women have severe pain, while others have few noticeable symptoms. The most common signs include:
- Pelvic pain, especially severe cramps during periods (dysmenorrhea)
- Long-term pain in your lower back and pelvis
- Pain during or after sex (dyspareunia)
- Pain with bowel movements or urination, often during your period
- Heavy menstrual bleeding or bleeding between periods
- Difficulty getting pregnant (infertility)
- Other issues like fatigue, diarrhoea, constipation, bloating, or nausea, especially around your period
How is Endometriosis Diagnosed?
Diagnosing endometriosis can be tricky. Dr. Madhushree Venkat will start by discussing your symptoms and medical history in detail. This is followed by a pelvic exam to check for any tenderness or unusual cysts.
The only way to confirm endometriosis for sure is through a surgery called a laparoscopy. This is a minor procedure where a thin camera is inserted through a small cut in your abdomen. This allows the doctor to see the endometrial tissue directly. Before this step, an ultrasound or MRI scan might be used to get a clearer picture and rule out other conditions.
Diagnostic Challenges
Many conditions can mimic endometriosis, such as pelvic inflammatory disease (PID), ovarian cysts, or irritable bowel syndrome (IBS). This often leads to delays in getting a correct diagnosis. It is important to see a specialist who is experienced in recognising the signs of endometriosis.
Stages of Endometriosis
Endometriosis is classified into four stages based on what is found during laparoscopy:
- Stage I (Minimal): A few small lesions with no significant scar tissue.
- Stage II (Mild): More lesions, still superficial, with no scar tissue.
- Stage III (Moderate): Deep implants and possibly endometriomas (chocolate cysts) on the ovaries.
- Stage IV (Severe): Many deep implants, large cysts, and thick bands of scar tissue (adhesions) that may bind organs together.
It’s important to know that the stage does not always correlate with the amount of pain you feel.
Causes and Risk Factors
The exact cause of endometriosis is not known. Some possible theories include:
- Retrograde Menstruation: When menstrual blood flows backwards through the fallopian tubes into the pelvic cavity instead of out of the body.
- Genetics: It often runs in families.
- Immune System Issues: Problems with the immune system may prevent the body from destroying misplaced endometrial tissue.
You may be at a higher risk if you:
- Have a mother or sister with endometriosis
- Started your period at an early age
- Have short menstrual cycles (less than 27 days) or heavy periods lasting more than 7 days
- Have never given birth
Complications of Endometriosis
The two main complications are:
- Infertility: Up to 50% of women with infertility may have endometriosis. The inflammation and scar tissue can block the fallopian tubes or affect egg quality. However, many women with mild to moderate endometriosis can still conceive, sometimes with medical help. If you are facing difficulties, learn more about our approach to infertility treatment in Airoli & Vikhroli.
- Cancer: The risk is still considered low, but women with endometriosis have a slightly higher relative risk of developing ovarian cancer later in life.
Treatment Options with Dr. Madhushree Venkat
Treatment depends on your symptoms, the severity of the condition, and whether you want to become pregnant. Dr. Venkat will work with you to create a personalised plan. You can explore all her gynaecological services to understand the full scope of care available.
- Pain Medication: Over-the-counter anti-inflammatory drugs (like Ibuprofen) can help manage cramping and pain.
- Hormone Therapy: Birth control pills, patches, or IUDs can help control hormones, reduce bleeding, and slow tissue growth.
- Conservative Surgery: For women who want to become pregnant or have severe pain, laparoscopic surgery can remove the endometrial tissue and scar tissue while preserving the uterus and ovaries.
- Fertility Treatment: If you are struggling to conceive, treatments like IVF (In Vitro Fertilisation) can be very effective.
- Hysterectomy: Removal of the uterus (and sometimes ovaries) is a last-resort option for severe cases when other treatments have failed and the family is complete.
Lifestyle Changes to Manage Symptoms
While diet and exercise are not cures, they can help you manage pain and improve your quality of life.
Eat Right:
- Try reducing foods that cause inflammation, like trans fats and red meat.
- Some women find relief by cutting down on gluten or following a low-FODMAP diet (which reduces certain hard-to-digest carbs).
- Include foods rich in Omega-3 fatty acids (like walnuts, flax seeds, and fatty fish), which can help fight inflammation.
- Exercise Regularly: Gentle, regular exercise can reduce stress, improve mood, and decrease pain by releasing endorphins. Yoga can be particularly helpful for stretching pelvic muscles.
- Try Alternative Therapies: Some women find relief through acupuncture, pelvic floor physical therapy, or massage. Always discuss these options with your doctor first.
Tips on Managing Endometriosis
- Keep a symptom diary to track your cycle and pain triggers.
- Use a heating pad or take warm baths to relax pelvic muscles and ease cramping.
- Prioritise rest, especially during your period.
- Seek support from friends, family, or support groups. Chronic pain can be isolating.
Find the Right Doctor for Endometriosis in Mumbai
Living with endometriosis can be challenging, but you don’t have to do it alone. Getting an accurate diagnosis and the right treatment is the first step toward taking back control of your life and your health.
Dr. Madhushree Venkat, a renowned Gynecologist and Laparoscopic Surgeon practicing in Airoli, Navi Mumbai, and Vikhroli, Mumbai, specialises in the diagnosis and management of endometriosis. With her expertise in advanced laparoscopic surgery and a compassionate approach, she provides personalised care to help manage your pain and achieve your family planning goals.
If you suspect you have symptoms of endometriosis, schedule a consultation with Dr. Madhushree Venkat to discuss your concerns and find a path forward.
Explore More:
- Struggling to conceive? Read about our comprehensive Infertility Treatment options.
- Learn about other common conditions we treat, like PCOS/PCOD.
- For expectant mothers, our expert High-Risk Pregnancy Care ensures you and your baby are in safe hands.