Endometriosis: Symptoms, Excision Surgery, and Fertility

Endometriosis is having a lot more open conversation around it lately — in the news, on social media, in the questions women bring to a first visit. That's a good thing, because it's one of the most commonly missed conditions in women's health, usually because severe period pain gets waved off as something to put up with. It isn't. It's a diagnosable condition with treatments that work, including surgery that can treat it and confirm it in the same procedure.

What Endometriosis Actually Is

Tissue similar to the lining of the womb grows outside the womb — on the ovaries, the fallopian tubes, or elsewhere in the pelvis. It still responds to your monthly hormones the same way the womb lining does, which means it bleeds and inflames every single cycle, with nowhere for that blood to go. That's what causes the pain — and over months and years, the scarring and adhesions that come with it.

The Symptoms That Get Dismissed

The clearest sign is severity, not just presence — period pain bad enough to stop you getting through your day is more suspicious of endometriosis than ordinary cramps that you can work around. Alongside that: bloating, a heaviness low in the abdomen, irregular periods, heavier bleeding than usual, pain during sex, and in some cases pain with bowel movements around your period. Some women are only diagnosed when they come in about difficulty conceiving, not pain at all — the symptoms don't always announce themselves the same way twice.

Endometriosis and Adenomyosis — Not the Same Thing

The two get confused often, including by women who've been told they have one when tests point to the other. Endometriosis is tissue growing outside the womb. Adenomyosis is similar tissue growing into the muscular wall of the womb itself. They can look alike on symptoms — heavy, painful periods — and can occur together, but they're seen differently on imaging and can need different treatment. Getting the distinction right matters for what happens next, which is exactly what the ultrasound and, where needed, the MRI are for.

How It's Diagnosed

An ultrasound comes first and may already show ovarian cysts and adhesions where endometriosis is present. An MRI gives more detail in more complex cases, including deep infiltrating endometriosis — disease that's grown further into pelvic structures rather than sitting on the surface. The Ca-125 blood test can be raised, though it's used alongside the imaging, not on its own. The definitive answer comes from laparoscopy: keyhole surgery that lets Dr. Mazumdar see the tissue directly and treat it in the same procedure.

Excision Surgery — What It Actually Involves

Excision means cutting the endometriotic tissue out, rather than just burning its surface — which is why it's generally considered the more thorough option, especially for deeper disease. Dr. Mazumdar does this laparoscopically: a camera and fine instruments through a few small cuts, so recovery is meaningfully faster than open surgery. It removes adhesions, removes chocolate cysts from the ovaries, and treats endometriotic spots directly — with your fertility plans factored in throughout, if having a baby is part of why you're here.

Endometriosis and Fertility

Many women with endometriosis conceive, some without any help at all, some with it. It's one of the causes of infertility Dr. Mazumdar specifically looks for during a fertility assessment, and treating the endometriosis itself can improve your chances. It's a reason to be assessed properly — not a reason to assume the worst before you've even been seen.

If period pain has been running your calendar for years and you've been told it's normal, that's exactly the kind of pain worth having properly investigated. Dr. Madhumita Mazumdar has performed over 1,500 laparoscopic procedures — book a visit and start with a conversation and an ultrasound, not more waiting.