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Best Doctors For endometriosis
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    Dr Anoop Gupta (DksYBmcnwW)

    Dr Anoop Gupta

    MBBS, MD-Obs & Gynecologist
    30 Yrs.Exp.


    30 + Years

    location icon Pristyn Care HQ
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    Dr. Sujatha (KrxYr66CFz)

    Dr. Sujatha

    MBBS, MS
    18 Yrs.Exp.


    18 + Years

    location icon Pristyn Care Clinic, Anna Nagar, Chennai
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    Dr. Monika Dubey (L11rBuqCul)

    Dr. Monika Dubey

    MBBS, MS - Obstetrics & Gynaecology
    14 Yrs.Exp.


    14 + Years

    location icon Pristyn Care Clinic, Noida
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  • What is Endometriosis
    Why does it happen
    Grades of Endometriosis
    Risks & Complications
    Myths and Facts
    Treatment Options
    Before and After
    Insurance Coverage

    What is Endometriosis?

    Endometriosis is a condition where the uterine blood lining that typically grows inside the uterus starts to grow outside it.

    In a healthy female body, the endometrium blood lining grows inside the uterus and sheds out through the vaginal opening during menstruation. However, in endometriosis, instead of flowing out, this menstrual blood starts to deposit around the small intestine, rectum, fallopian tubes, ovaries, fundas, and other body organs in the abdomen. With no way out, these blood deposits start to swell, causing unbearable pain, heaviness, exertion, fever, and at times, blood in the vomit. It also severely degrades a woman’s fertility by affecting both- the health and patency of the fallopian tubes.

    Why does it happen?

    While the exact cause of endometriosis is uncertain, reverse menses, that is, retrograde menstrual flow is the most commonly agreed upon medical theory.

    This understanding holds that while the endometrium responds to the hormones just as it should in a normal cycle and proliferates and enlarges during ovulation, it reverses its direction during menstruation. That is, instead of only flowing out of the vaginal opening, it reverses and flows inside the abdomen and creates layers of microscopic blood deposits across different organs around the uterus.

    Grades of Endometriosis

    • Grade 1 Endometriosis (Minimal Endometriosis)
    • Grade 2 Endometriosis (Mid Endometriosis)
    • Grade 3 Endometriosis (Moderate Endometriosis)
    • Grade 4 Endometriosis (Severe Endometriosis)

    Endometriosis Symptoms

    • Heaviness and pain in the abdominal area
    • Acute pain and abdominal cramps during menses
    • Pain during or after sex
    • Pain during urination or bowel movement
    • Difficulty in conception (female infertility issues)

    Diagnosis - Endometriosis


    Laparoscopy is the only successful diagnostic test for endometriosis (unless the patient develops an endometrioma cyst which can be diagnosed through an ultrasound).

    Procedure: As the name suggests, it is performed using a laparoscope, that is, a tiny catheter-like instrument with a camera and lens on its end.

    Once you are under the influence of anesthesia, the doctor makes a minor keyhole in the abdominal areas and injects carbon dioxide gas to lift it above the small intestines and create space for the procedure. Then, the laparoscope is inserted to provide a high-definition view of the internal organs on a digital monitor. This imaging helps provide the exact status of endometriosis, its severity, and grade.

    If needed, the laparoscopy test may be combined with the corresponding treatment.

    Self Diagnosis

    Self-diagnosis is next to impossible in the case of endometriosis. In fact, since the blood deposits are minuscule and microscopic, even diagnostic tests such as ultrasound fail to confirm the condition.

    Therefore, it is important that you connect with the doctor at the earliest site of symptom and undertake the diagnostic laparoscopy the soonest suggested.

    Diagnosis by Doctor

    While your symptoms are a good indication for detecting the probability, diagnostic laparoscopy is the only method to confirm the condition.

    Risks & Complications - Endometriosis

    During The Surgery

    The risks and complications during the surgical treatment for endometriosis depend directly on the kind of treatment method used.

    • Laparoscopic Excision: Mild risk of general anaesthetic complications and excessive bleeding
    • Laparoscopic Ablation: Mild risk of general anaesthetic complications, excessive bleeding, infection, and abrasions around the sites the ablation is used to burn the blood deposits. While the chances of recurrence remain, the treatment is long-term.
    • Laparoscopic Chromopertubation and Recanalization: Mild risk of bleeding or general anaesthetic complications.
    • Ovarian Cystectomy: Mild risk of general anaesthetic complications, excessive bleeding, infection, and damage to ovaries.
    • Hysterectomy: Mild- moderate risk of general anaesthetic complications, excessive bleeding, blood clots, and damage to the ureter, bladder, or ovaries.

    If Left Un-treated

    Endometriosis is an extremely painful condition, which, if left untreated, can be severed to grade III and IV, thus resulting in:

    Myths and facts on Endometriosis

    • Period pain is the same for all women.

    False. The pain and cramping felt during menses differ between every two women, and there is no standardized quantification of pain. This is especially true for women with endometriosis. The pain can become strikingly high with a burning sensation, nausea, and fever. Delay in treatment can severe the condition, leading to a similar pain being felt even in-between the periods.

    • Endometriosis is caused by having sex during periods. 

    No. While some medical studies do propose this theory, it is not accepted by a vast majority of medical practitioners. The exact cause for endometriosis still remains uncertain.

    • Endometriosis can be easily diagnosed.

    No. Endometriosis cannot be diagnosed unless through laparoscopic surgery.

    • There is no cure for endometriosis.

    Not entirely true. While there is no permanent cure for endometriosis, various medical and surgical procedures such as laparoscopy and ablation and laparoscopy and excision are great for providing not only immediate but long-term relief.

    • Women with endometriosis cannot become pregnant.

    False. While women with endometriosis do face trouble with infertility, various procedures such as recanalization of fallopian tubes, or assisted reproductive technology such as IVF or ICSI have made pregnancy possible with endometriosis.

    Endometriosis - Treatment Options & Cost

    Non-Surgical Options

    Symptoms of Grade I endometriosis can be managed through pain killers and oral contraceptives. The OC pills help halt ovulation through hormonal control. With no ovulation, the endometrium lining stops growing and in turn, provides the body a rest period. With this rest, the body heals itself and gradually absorbs the microscopic blood deposits to help control the pain and cluster symptoms.

    For similar results, the doctor may also suggest hormone therapy.

    However, note that this is not a long-term treatment. Hormonal medications must not be taken for longer than five years. Else, they pose a risk to lipid profile and increase the chances of heart-related diseases.

    Typically, doctor consultations and medications for endometriosis cost an average of INR 2000- INR 3000 in India.

    Surgical Options

    The surgical treatments for endometriosis vary basis the grade of severity and the patient’s individual needs for fertility or otherwise.

    • Grade II endometriosis: The minuscule blood deposits can be excised through LAPEX, that is, laparoscopy and excision. The average surgical cost is- between INR 60,000 to INR 80,000.
    • Grade III endometriosis: The slightly larger blood deposits can be burned through ablation via laparoscopy. The average surgical cost is- between INR 60,000 to INR 80,000.
    • Grade IV or Endometrioma (Chocolate Cyst): The endometrioma ovarian cyst can be removed through laparoscopic ovarian cystectomy. The average surgical cost is- between INR. 75,000 to INR 1,00,000.
    • LAPEX and Hysterectomy: While LAPEX is to excise every single endometrial tissue in the abdomen, hysterectomy is the procedure to remove the uterus. It is the last and permanent course of treatment for endometriosis for patients who do not desire further childbirth. Together, the surgery may cost anywhere between INR 75,000 to INR 1,00,000.

    Fertility Treatments of Endometriosis

    1. Blocked fallopian tubes: Recanalization can be performed to unblock the fallopian tubes and improve their patency. This is a fertility treatment done to improve the chances of natural conception if chromopertubation diagnosis that the fallopian tubes and blocked and unhealthy. On average, together, they cost between INR 60,000 to INR 80,000.
    2. Assisted Reproductive Technology: IVF or ICSI may be performed to assist healthy conception in a patient with endometriosis. On average, IVF costs between INR 1,25,000 to INR 1,80,000, while ICSI may cost between INR 1,40,000- INR 2,00,000.

    Before and After - Endometriosis Treatment

    Endometriosis Surgery Preparation

    LAPEX/ Laparoscopic Ablation / Ovarian Cystectomy/ LAPEX and Hysterectomy:

    • Confirm all your current medications, supplements, and herbal potions to your doctor. Certain medicines, such as ibuprofen, insulin, or blood thinners may be required to halt for a few days. This is because they can hamper the surgery and risk excessive bleeding during the procedure.
    • No surgery can be performed with imbalanced BP or sugar levels. This is why they must first be brought under control to proceed with the surgical treatment.
    • Do not eat or drink anything at least 4-6 hours before the surgery. Else, it may cause anesthesia-related complications.

    Fertility Treatments:

    • Begin fertility treatments as soon as endometriosis is under considerable control.
    • Quit smoking, drinking, or use of recreational drugs at least four weeks before the treatment.
    • Shift to a balanced diet and include at least 30 minutes of light workout every day.

    During the Surgery

    • All surgical treatments for endometriosis, be it LAPEX, laparoscopy and ablation, ovarian cystectomy, or LAPEX and hysterectomy, are performed under the influence of general anesthesia.
    • The procedures may take anywhere between 60-90 minutes.

    Before and After Endometriosis Surgery

    • LAPEX/ Laparoscopy and Ablation/ Ovarian Cystectomy: The surgery would provide immediate and long-term relief. However, chances of recurrence remain with time.
    • LAPEX and Hysterectomy: The surgery is the permanent resolve to endometriosis. However, it ends the patient’s capacity to give childbirth.
    • ART procedures (IVF/ICSI): Both promise higher chances of healthy conception.
    • Recanalization of fallopian tubes: The procedure would improve the health and patency of fallopian tubes, thereby aiding natural conception.

    Endometriosis Treatment - Insurance Coverage

    Yes, insurance covers the surgical treatment cost for endometriosis. However, fertility treatments are an exception. That is, all surgical options such as LAPEX, laparoscopy and ablation, ovarian cystectomy, or LAPEX and hysterectomy are covered under insurance as they fall under the ‘medically necessary’ list of treatments. However, fertility treatments such as recanalization, IVF, and ICSI are voted out because of their classification under treatments taken out of voluntary choice.

    Insurance coverage and the treatment cost capping varies case to case. Please confirm the same from your healthcare or insurance provider.

    Know More: Is Endometriosis Treatment Covered under Insurance ?

    Dr. Rahul Sharma (TEJFraQUZY)
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    FAQs around Endometriosis Treatment

    How common is endometriosis?

    More than 190 million women suffer from endometriosis worldwide.

    Which type of doctor treats endometriosis?

    Endometriosis is best treated by a gynecologist. At times, both- a gynecologist and endocrinologist, or general surgeon may work together to treat some of the co-morbidities such as thyroid, diabetes, etc.

    What are the best medications for endometriosis?

    The typical medications prescribed for endometriosis include birth control, pain killers, and hormone therapies. These halt ovulation and endometrial proliferation while the body rests and absorbs the existing blood deposits over the abdomen. However, they are not the best course of treatment because of their short-lived nature and commonly experienced side effects.

    What are the common side effects of birth control medications?

    Birth control pills take an average of 3 weeks to 3 months to properly adjust to the body. During this time, many patients report extreme mood swings, bloating, intermenstrual bleeding, nausea, drowsiness, and more. Also, they must not be taken for longer than five years, or they may risk heart-related diseases.

    What is the grade IV of endometriosis?

    Grade IV is the most advanced and critical stage of endometriosis. It involves severe blood adherations, unbearable pain, and endometrioma cyst on the ovary.

    Does endometriosis advance with age?

    Yes, endometriosis is a progressive condition that worsens with time. Typically, it starts to show symptoms after a few years of puberty, temporarily pauses during pregnancy, and permanently ends after menopause.

    Can you see endometriosis on an ultrasound?

    Yes, but only at grade III or grade IV with endometrioma cyst. Typically, the endometrial tissues deposited outside the uterus are so minuscule and microscopic that they cannot be seen except through a naked eye. Therefore, abdominal laparoscopy is the only gold standard of an endometriosis diagnosis.