Endometriosis Treatment in India

The treatment approach for endometriosis mainly involves – medication and surgery. The gynecologist will recommend the treatment option based on multiple factors like the severity of the symptoms, desire to get pregnant, etc.

Options for endometriosis treatment in India include:

1. Pain Medication: Medication is the most conservative therapy for managing endometriosis. If the symptoms are manageable, the doctor will suggest over the counter pain relief medicines such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), ibuprofen or naproxen sodium for painful menstrual cramps.
2. Hormone Therapy: Hormone supplements are used to reduce the pain associated with endometriosis and also reduce the levels of estrogen in the body. The hormone medication can slow growth of endometrial tissue and also prevent the development of new endometrial implants. The hormones can help in decreasing inflammation, scarring, and cyst formation. The hormone therapy includes:
   • Contraceptives – Birth control pills or patches, or vaginal rings: These can control the hormones that cause the growth of endometrial tissue each month. 
   • Hormone (Gn-RH) agonists and antagonists: These hormonal drugs block the production of ovarian-stimulating hormone and lower estrogen levels. They prevent menstruation and cause shrinkage of endometrial tissue. This creates menopausal effects that can be managed by low dose of estrogen or progestin. 
   • Progestin therapy: This include use of Intrauterine Device (IUDs) with levonorgestrel, contraceptive implant, contraceptive injection or progestin pill. These can stop menstrual periods and the growth of endometrial implants to relieve signs and symptoms of endometriosis. 
   • Aromatase inhibitors are used  to reduce the amount of estrogen in the body.
3. Surgery: Surgical intervention is recommended by the doctor when the symptoms are severe and medication fails to improve the condition. The goal of the surgery to remove the endometrial implants and provide relief from the symptoms like pain. It is considered the most effective treatment of endometriosis.

   Conservative surgery for endometriosis has the advantage that there are better chances of getting pregnancy after this procedure. In this, the endometrial tissue is removed while preserving the uterus and ovaries. 

   • Laparoscopic surgery for endometriosis is a less invasive (keyhole) procedure and the most commonly used endometriosis treatment these days. During the surgery, the surgeon makes a small incision on the abdomen and inserts a thin instrument, called a laparoscope, through it. Then it is used to remove or destroy endometrial implant by applying heat, electric current, a laser, or special gas to these tissues. This procedure can also be used to treat ovarian cysts which form due to endometriosis. 
   • Hysterectomy (removal of uterus) and removal of ovaries can be used to treat the endometriosis symptoms like heavy bleeding during menstruation, painful cramps, etc. However, removing the ovaries and uterus might lead to some problems and long-term effects on health. Removal of ovaries results in early menopause which carries a risk of developing certain cardiovascular (heart) diseases and metabolic conditions. This surgery also affects the hormone levels and certain hormone therapies might be recommended by the doctor.
   • If you do not want to have children in the future or if keyhole surgery cannot be used, hysterectomy alone or with removal of ovaries is the treatment option.
4. Infertility treatment: Laparoscopy can improve the chances of pregnancy but if you are still unable to conceive, fertility treatments like in vitro fertilization (IVF) is the best option for desirable candidates. IVF is a type of assisted reproductive therapy in which the egg and sperm are allowed to fertilize in the laboratory and then resulting embryo is transferred to the mother’s womb.