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Table Of Index

What is Endometriosis?

Why does it happen?

Grades of Endometriosis

Risks & Complications

When to consult a doctor?

Endometriosis Doctors

Questions to Ask Your Doctor

Treatment Options & Cost

Insurance Coverage

Recovery Rate

Long Term Outlook

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 I

Grade II

Grade III

Grade IV

Causes

Uncertain

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

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 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.

Diagnostic Laparoscopy for Endometriosis

Severity

Endometriosis grade 1 is the first stage of endometriosis with only minimum to mild symptoms of pain felt during menstruation.

Typically, the pain can be relieved through medications and hormone therapy.

Risks & Complications

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.

Celebrities with Endometriosis
- Hilary Clinton (Former Presidential candidate, US secretary, and first lady of United States)
- Queen Victoria (The famous British monarch)
- Marlyn Monroe (The famous American actress and style icon)
- Katrina Kaif (One of the top Bollywood actress)
- Celena Jaitley (Indian actress and Miss India, 2001)
- Sumona Chakravarti (The Kapil Sharma Show fame actress)
- Padma Laxmi (Indian author, actress, and food expert)
- Jamie King (American actress and model)
- Halsey (Grammy winner singer)
- Julianne Hough (American dancer, actress, and singer)
- Tia Mowry (The “Sister, Sister” famed Actress)
- Susan Sarandon (Academy award-winning American actress and activist)
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.
Prevention
Since there is no definite identified cause of endometriosis, medical sciences currently lack the methods of prevention.

When to consult a doctor?

Consult your gynecologist as soon as you experience :

Regular abdominal pain with heaviness and exertion
Mild to no menstrual blood with extreme pain and cramping
Difficulty in conception

Our endometriosis Specialist

Questions to Ask Your Doctor

What is my grade of endometriosis?

Can I be treated through medications, or is surgical treatment necessary?

What is the health and patency of my fallopian tubes?

What are my chances at natural conception?

What are my best options for fertility treatments using assisted reproductive technology?

What are the different modes of payment accepted?

Which insurances do you accept?

Treatment Options & Cost

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.

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.

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.

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.

Treatment for endometriosis involves both- Ovarian Cystectomy/ Hysterectomy. Each can be performed in either of the two ways-

Laparoscopy: This is a neo-modern method where the surgery is performed through a laparoscope, that is, a catheter-like instrument with a camera and light on its end. The method is minimally invasive and promises quicker recovery with reduced chances of risk or complications.

Open cut method: As the name suggests, it is an open cut incision and stitch method. It is comparatively more invasive and needs more recovery time post-surgery.

Fertility Treatments

Recanalization of fallopian tubes : To unblock the fallopian tube blockage because of endometrial blood deposits and aid natural conception.

Invitro-fertilization (IVF): For female factor fertility issues where the partner’s sperms are healthy and motile.

Intracytoplasmic sperm injection (ICSI): For female factor fertility issues where the partner’s sperms are of lower health and motility.

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.

As you wake up from the effects of anesthesia, you’ll feel considerable relief in the abdominal area. However, you might feel slight discomfort, pull, and itching at the surgical site. For the same, you will be provided with mild painkillers and antibiotics.

In the case of laparoscopic procedures, you may be either be discharged the same day or suggested 1-day hospitalization to monitor your health and recovery. For conventional open cut surgery, 2-3 days of hospitalization may be suggested.

LAPEX/ Laparoscopy and Ablation/ Ovarian Cystectomy
The surgery would provide immediate and long-term relief. However, chances of recurrence remain with time.

Recanalization of fallopian tubes
The procedure would improve the health and patency of fallopian tubes, thereby aiding natural conception.

ART procedures (IVF/ICSI)
Both promise higher chances of healthy conception.

LAPEX and Hysterectomy
The surgery is the permanent resolve to endometriosis. However, it ends the patient’s capacity to give childbirth.

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.

Recovery Rate

For laparoscopic surgeries, the recovery period runs around 3-5 days. Whereas open-cut surgeries require a rest period of a minimum of 2 weeks.

Video testimonial - by patient

Video on the disease and treatment - by Pristyn Care doctor

Latest Research

FAQ

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.

Why Choose Pristyn Care for Endometriosis Treatment?

Pristyn Care brings the most advanced and holistic gyne treatments with its experienced doctors and latest laparoscopic and laser technology in 15+ cities in India. We are associated with multiple reputed gyne-clinics and super-specialty hospitals, giving you the option to choose amongst the best hospitals that suit your needs, be it the hospital distance, its infrastructure, or insurance panel.

As you choose Pristyn Care for your treatments, you get some of the added benefits. These include:

Free online/ in-clinic consultations: We offer free consultations. Also, you have the choice to speak with the doctor in-clinic or offline, sitting from the comfort of your home. You can ask as many questions, and we ensure we give you the right and detailed answers.

Both surgical and fertility treatments available: We perform both- surgical as well as fertility treatments for endometriosis. That is, we offer laparoscopy ablation, LAPEX, laparoscopic ovarian cystectomy, laparoscopic chromopertubation, and recanalization of the fallopian tube, IVF, ICSI, and LAPEX and hysterectomy.

Free transportation to and from the hospital: We provide free cab pick up and drop off from and to your residence on the day of surgery.

Minimal-no waiting time for hospital admission: We perform most of our admission formalities beforehand, so you do not have to wait for hospital admission at the site.

All paperwork done on your behalf: We do all your hospital admission and discharge paperwork ourselves on your behalf to reduce your hassles and provide a seamless patient experience.

Multiple payment options: We accepts all modes of payment including cash, credit, and debit card.

All insurances accepted: We accept all insurances and offer cash-less facilities at most of the hospitals.

No cost EMI option: You can also opt for the No cost EMI option while paying for your medical bills.

Free follow-up: We provide free follow-up post consultations to ensure a complete and smooth recovery.

How to Book an Appointment with a Pristyn Care Gynecologist for Endometriosis?

Booking an appointment with a Pristyn Care gynecologist is easy.

Simply call us directly or fill out our ‘Book my Appointment’ form. It would ask you just four basic questions such as ‘Your name’, ‘Contact’, ‘Disease name’, and ‘City’. Just fill them and click ‘submit’. Our medical coordinators will call you shortly and help you speak to a doctor of your choice.