​Endometriosis​​

Endometriosis is a disorder experienced by women who have menstrual periods. The inner lining of the uterus is called the endometrium. This is normally shed during a woman’s monthly menstrual cycle through her vagina. If you are suffering from endometriosis, this lining develops in other places such as the ovaries, fallopian tubes, vagina or the intestine. 

The exact cause of endometriosis is not known, but it is believed to occur when the uterus lining moves backwards through the fallopian tubes and passes through the pelvic cavity, which is the space inside the pelvis containing the reproductive organs. The endometrium may form on the surface of the reproductive organs, and bleed out during the menstruation cycle. This causes the surrounding tissues to become inflamed. It may also cause formation of scar tissues as well as cysts in the ovaries. ​

A common reason for endometriosis is thought to be surgery. Sometimes a c-section or hysterectomy (surgical removal of the uterus) may cause these endometrial cells to attach themselves to the scar. It may also be due to an immune system disorder, in which case your body’s immune system is unable to identify and destroy abnormal endometrial cells.​​​


There are several and varied symptoms of Endometriosis. At times, there are no symptoms present but when they occur, they may include the following:

  • Extremely painful menstrual cramps

  • Abnormally heavy and prolonged menstrual period at irregular intervals

  • Pain experienced during sex

  • Infertility​ or difficulty in becoming pregnant

  • Repeated miscarriages

  • Cramps in the abdominal region (stomach) 

  • Persistent back or thigh pain during the monthly menstruation cycle

  • Painful bowel movements or urination

  • Bleeding in the rectum or bladder

  • Fatigue​, diarrhoea​, constipation​ or nausea, especially during periods

​Your symptoms may not be connected to the severity or extent of your condition. Sometimes patients at a very advanced stage of the disease may experience very mild symptoms, and at other times, patients with very severe symptoms may only be at a very mild stage of the disease.​​

If you are experiencing any of the symptoms mentioned above, make it a point to see a doctor working with the Women's Health Care Service Line​ at The Aga Khan University Hospital. Sometimes, the exact cause of pain may be difficult to find but consulting with a physician may help you to avoid further pain and complications.

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. ​Here are some tips to help get you started. ​​

In order to confirm the diagnosis of endometriosis, your doctor will conduct a preliminary pelvic exam. This will allow your doctor to check for abnormalities such as cysts​ or scars. Your doctor may also ask for an ultrasound, which is a procedure that gives an image of the inside of your abdominal and pelvic region. A device called a called a transducer is used during this test. This device is pressed against your stomach or inserted inside your vagina. It will allow your doctor to see your reproductive organs more clearly, and identify whether there is any abnormal growth.

Your doctor may also perform a test known as a laparoscopy. This is a surgical procedure, during which the surgeon makes a small cut in the stomach in order to insert a scope (a viewing instrument). Through this, he or she will be able to locate any fragments of skin known as endometrial implants. If these are suspected to be present, they will be biopsied (examined) in order to confirm their presence and gauge their size.

There is no cure for endometriosis, but your doctor can help you manage the symptoms in a number of ways.

  • Prescribe medications for painful cramps
  • Drugs to reduce inflammation and swelling

  • Drugs known as “GnRH agonists”, which block the production of the hormones causing the symptoms

  • Prescribe medications that block the production of hormones and suppresses the growth of endometrial tissue

  • Conservative surgery to remove the growth of abnormal tissue

  • Procedures to assist pregnancy such as in vitro fertilization

  • In extreme cases, doctors may suggest removal of the uterus through surgery

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage

​​​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.​