The short answer: Endometriosis is a common, non-cancerous condition in which tissue similar to the womb lining grows outside the womb, causing painful periods, pelvic pain (pet ke neeche dard, पेट के नीचे दर्द) and sometimes difficulty getting pregnant; many women search for endometriosis ka ilaj (एंडोमेट्रियोसिस का इलाज). Most women start with painkillers and hormonal treatment, and not everyone needs surgery. Keyhole surgery (laparoscopy) is considered when medicines do not help enough, when pain is severe, when a cyst on the ovary (chocolate cyst) needs attention, or when fertility is a concern. To understand the condition itself, see our page on understanding endometriosis. Dr. Nishtha Tripathi Patel sees patients at Sterling Hospitals (Sindhubhavan Road), KD Hospital and Welcare Speciality Hospital in Ahmedabad; laparoscopic surgery is available at all three.
On this page
- The Principles of Endometriosis Treatment
- Medical Management
- Laparoscopic Surgery for Endometriosis
- Endometrioma: A Special Consideration
The Principles of Endometriosis Treatment
There is no permanent cure for endometriosis, but for most women the symptoms can be well controlled. The goals of treatment are pain control, protecting fertility, limiting the effect of the disease over time, and a good quality of life. The treatment pathway is individualised based on the severity of disease, the patient’s symptoms, her fertility wishes, and whether she has a chocolate cyst on the ovary (endometrioma) or deep endometriosis affecting the bowel or bladder.
If you want to become pregnant, tell your doctor early. Hormonal treatments stop you conceiving while you take them, so the plan is different: many women with endometriosis conceive naturally, while others are helped by surgery, fertility treatment such as IVF, or both.
Medical Management
First-line medical treatment suppresses the menstrual cycle and reduces oestrogen-driven endometriotic activity:
- Painkillers — anti-inflammatory painkillers taken around periods are often the first step and can be combined with hormonal treatment
- Combined oral contraceptive pill (COCP) — taken continuously (no pill-free break) to suppress menstruation; effective for pain and widely available
- Progestogens — norethisterone, desogestrel, or injectable medroxyprogesterone acetate; suppress endometriosis and reduce periods
- Levonorgestrel IUS (Mirena) — releases progestogen directly into the uterus; can ease pain and heavy bleeding, especially when adenomyosis is also present
- GnRH agonists — leuprolide or goserelin; induce a medical menopause; can work well but cause menopause-like side effects, and are usually limited to about 6 months without add-back HRT because of their effect on bone strength
- Dienogest — a progestogen tablet taken daily, available in India and widely used for endometriosis pain; irregular spotting is common in the first months
Hormonal treatments control symptoms while you take them; they do not remove existing cysts or scar tissue, and symptoms may return when they are stopped.
Laparoscopic Surgery for Endometriosis
Laparoscopy (keyhole surgery through small cuts in the tummy) can confirm endometriosis and treat it in the same operation. You do not always need a laparoscopy before starting treatment: symptoms, examination and scans are often enough to begin. During surgery, endometriosis patches are cut out (excision) or burnt away (ablation), chocolate cysts are removed while keeping as much healthy ovary as possible, and scar tissue (adhesions) is freed. Many specialists prefer excision, particularly for deeper disease. Most women go home within a day or two and recover faster than after open surgery. Endometriosis can come back after surgery, and hormonal treatment afterwards is often advised to lower that chance if you are not trying to conceive.
Deep infiltrating endometriosis — involving the bowel, bladder, or ureters — needs careful planning, often with an MRI scan first. If surgery is needed, it should be done by a surgeon experienced in complex pelvic surgery, sometimes together with a bowel or urinary-tract surgeon. Not every woman with deep endometriosis needs an operation; for some, medicines control the symptoms well.
Endometrioma: A Special Consideration
An ovarian endometrioma (chocolate cyst) can reduce the number of eggs in the ovary (ovarian reserve), and surgery on the ovary can reduce it further, so the decision to operate is weighed carefully, especially if you want children. Small cysts that cause no problems can sometimes be watched with repeat scans. A cyst that grows, looks unusual on the scan, or is found after menopause should be reviewed by a specialist. When surgery is needed, the goal is to remove the cyst using cystectomy technique — stripping the cyst wall — rather than simple drainage, which has a high recurrence rate. In women planning IVF, the timing of surgery relative to egg retrieval cycles needs careful discussion.
Before your visit, this guide on preparing for a specialist appointment lists the scans, reports and questions worth bringing.
For endometriosis treatment in Ahmedabad, contact Dr. Nishtha Tripathi Patel: +91 76988 00333.