The short answer: Should you worry about cancer if you have endometriosis? For most women, no. Endometriosis (often searched as endometriosis kya hai, एंडोमेट्रियोसिस क्या है) is not cancer and does not usually turn into cancer. It is linked with a small rise in the chance of some ovarian cancers, mainly in women with a chocolate cyst (चॉकलेट सिस्ट, an ovarian cyst filled with old blood), but the overall chance stays low. You do not need special cancer tests. What helps is simple: keep any ovarian cyst under review, know which new symptoms to report, and get any bleeding after menopause checked. The plan below explains each step.
On this page
- What Is Endometriosis?
- Recognising the Symptoms
- Does Endometriosis Increase Cancer Risk?
- A Simple Plan If You Have Endometriosis
- When to Seek Specialist Evaluation
What Is Endometriosis?
Endometriosis is a chronic condition in which tissue similar to the lining of the uterus (the endometrium) grows outside the uterus — on the ovaries, fallopian tubes, bladder, bowel, or the peritoneal lining of the pelvis. Like the endometrial lining inside the uterus, this displaced tissue responds to oestrogen: it swells, bleeds, and attempts to shed each month. Because there is nowhere for the blood to go, it triggers inflammation, scarring, and the formation of adhesions — fibrous bands that bind organs together. Our page on understanding endometriosis covers its causes, diagnosis and treatment in more detail.
An estimated 190 million women worldwide are affected. In India, endometriosis is significantly under-diagnosed — partly because period pain is widely normalised and partly because many women wait years before the condition is investigated properly. The average delay between the onset of symptoms and diagnosis is seven to ten years.
Recognising the Symptoms
The hallmark symptom is dysmenorrhoea — painful periods that disrupt daily life. But endometriosis can also present as:
- Chronic pelvic pain unrelated to menstruation
- Pain during or after intercourse (dyspareunia)
- Pain on urination or opening the bowels, particularly during a period
- Heavy or irregular periods
- Fatigue, bloating and low mood — sometimes dismissed as irritable bowel syndrome (IBS) or anxiety
- Difficulty conceiving
Importantly, the severity of pain does not correlate with the extent of disease. Some women with widespread endometriosis have minimal discomfort; others with small lesions are debilitated. Never use pain level as a guide to whether endometriosis is serious.
Does Endometriosis Increase Cancer Risk?
This is one of the most common questions I hear. The short answer: endometriosis is not cancer, but certain subtypes — particularly endometrioma (ovarian endometriosis) — are associated with a modestly elevated risk of clear-cell and endometrioid ovarian cancer. The absolute risk remains small. Regular check-ups with your gynaecologist are still sensible, mainly because some symptoms of ovarian cancer (bloating, pelvic discomfort, feeling full quickly) can resemble endometriosis, so a new or different pattern is worth reporting.
A 2021 review that combined many studies found that the overall chance of ovarian cancer was a little under double in women with endometriosis. Because ovarian cancer is uncommon to begin with, the large majority of women with endometriosis never develop it; our article on what the evidence shows explains these numbers. Routine CA-125 blood tests are not needed just because you have endometriosis: endometriosis itself often raises CA-125, so the test is used when a scan or new symptoms call for it.
A Simple Plan If You Have Endometriosis
- If you have a chocolate cyst: your gynaecologist will suggest how often to repeat the ultrasound. A cyst is looked at more closely if it grows, has solid parts on the scan, or appears after menopause.
- Know the symptoms to report: bloating, feeling full quickly, pelvic or tummy pain, or needing to pass urine urgently that is new and happens on most days (more than 12 times a month), especially if it feels different from your usual endometriosis pain. The first tests are usually a pelvic ultrasound and a CA-125 blood test (most labs treat below 35 U/mL as normal). Most women with these symptoms do not have cancer.
- After menopause: endometriosis pain often settles. A new cyst, new pain, or any bleeding after menopause should be checked, even if the bleeding happens only once; see bleeding after menopause.
- No operation is needed just to lower the cancer risk: removing healthy ovaries only for this small risk is not routinely advised. Surgery is for pain, fertility, or a cyst that needs attention.
When to Seek Specialist Evaluation
You should seek a specialist opinion if:
- Your periods are consistently painful enough to require strong painkillers or time off work
- You have been trying to conceive for more than 12 months without success (6 months if over 35)
- Pelvic pain is present outside your period
- You have a known ovarian cyst or endometrioma on ultrasound
- Your symptoms are worsening over time despite standard medical management
You do not always need an operation to be diagnosed. Symptoms, an examination and an ultrasound (sometimes an MRI) are often enough to start treatment. A scan can show chocolate cysts and some deeper disease but can miss small patches on the lining of the pelvis, which are seen only at keyhole surgery (laparoscopy). Your gynaecologist will discuss whether medicines, surgery or both suit you; our guide to endometriosis treatment options explains each choice.
Dr. Nishtha Tripathi Patel is a gynaecological oncosurgeon at Sterling Hospitals, KD Hospital, and Welcare Speciality Hospital, Ahmedabad. For consultation: +91 76988 00333.