Endometriosis affects an estimated 1 in 10 women of reproductive age worldwide — yet in India, the average woman waits 7 to 10 years between her first symptom and a confirmed diagnosis. This delay is not simply a medical failing; it is a cultural one. Pain is normalised. Suffering is expected. Women are told to ‘manage’ their periods, to have a baby and ‘it will get better,’ or that their pain is psychological. Dr. Shweta Mendiratta, endometriosis specialist in Faridabad, is here to challenge every one of those myths.
What Is Endometriosis?
Endometriosis is a condition in which tissue similar to the lining of the uterus (endometrium) grows outside the uterus — on the ovaries, fallopian tubes, bladder, bowel, and other pelvic structures. This tissue behaves like uterine lining: it thickens and bleeds with every menstrual cycle. But because the blood has nowhere to go, it causes inflammation, scarring, and the formation of adhesions (bands of fibrous tissue that bind organs together).
Over time, endometriosis can cause chronic pain, distorted pelvic anatomy, damaged fallopian tubes, and impaired egg quality — all of which contribute to infertility.
The Symptoms Most Women Dismiss
- Painful Periods (Dysmenorrhoea)
Period pain that requires you to miss school, work, or social events is not normal. Normal periods may cause mild cramping that responds to a painkiller. Endometriosis-related pain is often severe, starts before bleeding begins, and persists throughout the period — sometimes radiating to the back or legs.
- Pain During or After Sex (Dyspareunia)
Deep pain during sexual intercourse, particularly in certain positions, is a classic endometriosis symptom that many women are too embarrassed to mention. This pain typically occurs when endometrial deposits are present on the uterosacral ligaments or in the pouch of Douglas (the space behind the uterus).
- Painful Bowel Movements or Urination
If you experience pain when opening your bowels or passing urine — particularly during your period — endometriosis may have spread to the bowel or bladder. Many women with this symptom are first sent to a gastroenterologist and spend years being treated for irritable bowel syndrome (IBS) before endometriosis is considered.
- Chronic Pelvic Pain
Unlike period pain, chronic pelvic pain is present throughout the month — not just during menstruation. Women often describe it as a dull ache, pressure, or a feeling of heaviness in the lower pelvis. This is frequently dismissed as ‘stress’ or ‘anxiety’ and goes uninvestigated for years.
- Heavy Periods
While not always present, many women with endometriosis experience heavier-than-normal periods, sometimes with clots. If you are changing pads or tampons every one to two hours, this warrants medical evaluation.
- Bloating and Gastrointestinal Symptoms
‘Endo belly’ — severe abdominal bloating associated with endometriosis — can be so pronounced that some women look visibly pregnant during their cycle. Nausea, diarrhoea, and constipation around the period are also common and frequently misattributed to IBS.
- Infertility
Up to 40% of women with infertility have endometriosis as an underlying cause — and in many cases, infertility is the first symptom that prompts investigation. Endometriosis impairs fertility through multiple mechanisms: distorted anatomy, blocked tubes, toxic peritoneal fluid, and impaired embryo implantation.
Why the Diagnostic Delay in India Is So Dangerous
Every year without treatment, endometriosis can progress. Deposits grow larger, adhesions become more extensive, and the damage to reproductive organs becomes more difficult to reverse. Women who might have had a straightforward laparoscopic excision at stage 1 or 2 may find themselves facing complex surgery involving the bowel or bladder by the time they receive a diagnosis at stage 3 or 4.
Beyond fertility, untreated endometriosis imposes a profound quality-of-life burden. Chronic pain affects productivity, relationships, mental health, and overall wellbeing. The economic cost of untreated endometriosis in India — in terms of lost working days, healthcare visits, and failed fertility treatments — is enormous.
How Is Endometriosis Diagnosed?
The definitive diagnosis of endometriosis is made by laparoscopy — a minimally invasive surgical procedure in which a camera is inserted through a small incision to directly visualise and biopsy endometrial deposits. However, a clinical diagnosis can often be suspected on the basis of:
- Symptom history and pattern
- Pelvic examination (tenderness, nodularity, fixed uterus)
- Transvaginal ultrasound (especially for ovarian endometriomas)
- MRI (particularly for deep infiltrating endometriosis)
Dr. Shweta Mendiratta uses a combination of clinical assessment and imaging to guide surgical planning, ensuring that each procedure is targeted and minimally disruptive.
Treatment of Endometriosis
Treatment depends on the severity of disease, your symptoms, and your fertility goals:
- Medical management: Hormonal therapies (combined OCPs, progestins, GnRH analogues) to suppress the growth of endometrial deposits
- Laparoscopic excision: Surgical removal of endometrial deposits, cysts (endometriomas), and adhesions — the gold standard for improving both pain and fertility
- Fertility-preserving surgery: Dr. Mendiratta specialises in excising endometriosis while protecting the ovaries and tubes
- Post-operative medical therapy: To suppress recurrence after surgery
Frequently Asked Questions (FAQs)
Q1. Can endometriosis be confirmed by a blood test?
There is no definitive blood test for endometriosis. CA-125 may be elevated but is not specific. Definitive diagnosis requires laparoscopy.
Q2. Will pregnancy cure my endometriosis?
Pregnancy may temporarily suppress endometriosis symptoms, but it does not cure the condition. Symptoms typically return after delivery and breastfeeding end.
Q3. Can I still get pregnant if I have endometriosis?
Yes. Many women with endometriosis conceive — either naturally or with treatment. Early diagnosis and appropriate surgical management significantly improve fertility outcomes.
Q4. Does endometriosis always cause pain?
No. Some women with severe endometriosis have minimal or no pain, while others with mild disease experience debilitating symptoms. The degree of pain does not correlate with the extent of disease.
Q5. How do I know if my period pain is ‘endometriosis level’ pain?
If your pain is not controlled by standard over-the-counter painkillers, interferes with daily functioning, or is accompanied by the other symptoms described in this article, you should seek specialist evaluation.
Get In Touch With Dr. Shweta Mendiratta
Phone: +91-8130048652 | +91-9999093503
Email: shwetasmendiratta@gmail.com
Yatharth Super Speciality Hospital
Plot No 9, Sector-20, Krishna Nagar, New Industrial Township, Faridabad, Haryana 121007
Phone: +91 8178-939442
Mediclub Gynae ‘N’ Neuro Clinic
Pilot No. 857 Sector 21 C, Faridabad Delhi, Haryana 121001
