Endometriosis Clinic

Endometriosis Clinic

Endometriosis is a gynaecological disorder where tissues similar to that of the uterine lining grow in other parts of the body. When this tissue spreads to inappropriate areas, you can face uncomfortable symptoms that can hamper your everyday life. They can also lead to superficial lesions, ovarian cysts, scar tissue, deeper nodules, and adhesions within the body.

Some body parts where endometriosis occurs include fallopian tubes, back and outside of the uterus, ovaries, vagina, bladder and ureters, peritoneum, rectum, intestines, and the diaphragm.

Endometriosis is a relatively common gynaecological condition that tends to negatively impact the life of the affected person. It can result in long-term pain, fertility issues, and a disturbed menstrual cycle. The symptoms of endometriosis can often be managed with proper treatment and care.

Endometriosis commonly affects women between the age of 25 and 40 years. It can also happen to younger females during their teenage years. Although many females manage to get relief from endometriosis symptoms after their menopause, it can still cause discomfort and pain.

Certain risk factors can increase your susceptibility of developing the disease. Following are some of those:

  • A family history of endometriosis.
  • Early menses.
  • The duration of menstrual flow and the length of the menstrual cycle.
  • Defects in your uterus and fallopian tubes.

The exact cause that leads to developing endometriosis is unknown. When someone has the condition, the uterine tissue starts appearing in the wrong place. When it spreads to areas beyond the ovaries, uterine cavity, fallopian tubes, intestines, or within the pelvic cavity, it can lead to development of painful symptoms. This pain is associated with increased inflammation and often fibrosis and adhesions.

When the tissue resembling the lining of the uterus starts growing outside the uterus, it results in the formation of adhesions or scar tissue. These scar tissue sections can result in the fusion of the organs and create abnormal connections between them. All this causes discomfort and pain. Following are the main causes that lead to the development of endometriosis:

  • Retrograde menstruation
    This condition is characterised by back flow of the menstrual blood containing the endometrial cells into the pelvic cavity or the uterus via the fallopian tubes instead of going out of the body. The endometrial cells in the menstrual blood get stuck to the walls of the pelvic cavity when they grow and thicken. They eventually bleed over each menstrual cycle.
  • Transformation of peritoneal cells
    Some experts propose that hormones or immune factors promote transformation of peritoneal cells into cells that appear similar to endometrial cells.
  • Embryonic cell transformation
    Sometimes, during puberty, hormones including oestrogen may lead to the transformation of embryonic cells into endometrium-like cells.
  • Surgical scar implantation
    The endometrial cells may stick to a surgical incision site after different types of surgeries, such as a hysterectomy or C-section.
  • Endometrial cell transport
    The blood vessels or lymphatic system may transport the cells of the endometrium to other parts of the body.
  • Immune system disorder
    If the immune system is compromised, the body may fail to identify or eliminate endometrium-like tissue. So, it spreads outside of the uterus.

Pelvic pain with menstrual periods is the primary symptom of endometriosis. Although a lot of women face cramping pain during their menstrual periods, endometriosis menstrual pain is typically far worse than usual. Pain also tends to escalate over time. Following are the common signs and symptoms of endometriosis:

  • Dysmenorrhea or painful periods
    Cramping and pelvic pain may start before and extend several days into a menstrual period. You may also experience abdominal pain or lower back pain.
  • Pain with intercourse
    Pain during or after sex is common with endometriosis.
  • Excessive bleeding
    You may experience heavy menstrual periods occasionally or bleeding between periods (intermenstrual bleeding).
  • Pain with urination or during bowel movements
    You're susceptible to experience these symptoms during a menstrual period.
  • Infertility
    Endometriosis is sometimes first diagnosed in those who seek infertility treatment.
  • Other signs and symptoms
    You may experience diarrhoea, fatigue, bloating or nausea, constipation, especially during menstrual periods. The pain severity is not a reliable indicator of the extent of endometriosis. You could have advanced endometriosis with no or little pain, or mild endometriosis with severe pain.

Sometimes, endometriosis is mistaken for other conditions causing pelvic pain like ovarian cysts or pelvic inflammatory disease. It may be mistaken for irritable bowel syndrome— a condition causing bouts of constipation, diarrhoea, and abdominal cramping. IBS can be associated with endometriosis, which sometimes complicates the diagnosis.

Many endometriosis cases are diagnosed based on the symptoms. Painful, heavy menstrual periods cause many patients to seek help from their healthcare providers. The doctor usually starts asking about the history of previous pregnancies, medical and personal history, history of previous pregnancies and family history of endometriosis during the appointment. You may also be asked to go for a pelvic examination. If he feels like more information is needed, he will most likely perform pelvic imaging starting with an ultrasound.

Depending on your symptoms, ultrasound reports, and physical examination, your doctor may order you to do an MRI for further endometriosis mapping. A laparoscopy may be performed both for definitive diagnosis and treatment. It can serve as a useful way of confirming endometriosis as the surgeon uses a small camera known as a laparoscope during the procedure to remove a small sample of the suspected area’s tissue, which is then sent to a laboratory for further assessment.

At certain times, endometriosis is diagnosed coincidentally. Every endometriosis patient does not experience symptoms. In these conditions, the disease may be discovered during a different procedure.

After carefully assessing your condition, your doctor will design a treatment plan for your condition based on a few factors, such as the plan for future pregnancies severity of the endometriosis, the plan for future pregnancies, the severity of your symptoms, and your age. The main focus of your treatment plan will be to manage your pain and improve your fertility problems. This can be achieved through medications and surgery.

Endometriosis is a chronic disease, and even though many patients experience relief from their symptoms after surgery, those can recur after a few years. The severity of your condition is a deciding factor in determining how quickly it comes back after surgery. Sometimes, surgery is combined with medications to ensure an optimum outcome. Sometimes, pelvic floor exercises are also recommended to relieve central nerve pain.

Over a period of time, the endometrial-like tissue growing outside the uterus can develop cysts, scar tissue, and adhesions. This can result in long-term pain, especially during menstrual periods. Many endometriosis patients may also face difficulties getting pregnant. This issue can sometimes be resolved with treatment.


Here are some complications of this condition:

  • Infertility
    The primary complication of endometriosis is fertility issues. About one-third of females with the condition face difficulties getting pregnant. For a female to get pregnant, the ovary must release an egg, go through the surrounding fallopian tube, get fertilised, attach itself to the wall of the uterine cavity to start getting developed. The tube may be obstructed due to endometriosis and the sperm and egg won’t be able to unite. However, the condition also appears to affect fertility indirectly, supposedly by damaging the egg or sperm.
  • Cancer
    Those with endometriosis are more susceptible to developing ovarian cancer. However, the overall lifetime risk is relatively low. Another form of cancer called endometriosis-associated adenocarcinoma can occur later in life in people with endometriosis.

If you notice any of the above-mentioned symptoms of endometriosis, you must talk to an expert. If you are located in Indore, you can visit the Endometriosis Clinic at Kokilaben Dhirubhai Ambani Hospital, Indore and book an appointment with an expert doctor who will guide you to the next step. Even if your pain is mild to moderate, you might still have the condition. Your condition’s severity of the problem is not decided by the intensity of your pain. Consult the best endometriosis specialists in Indore for further care.