Select Page

Endometriosis is a gynaecological condition characterised by presence of endometrial tissue outside the uterus. It is a wide spectrum of illness and is determined by the extent of endometrial deposits on fallopian tubes, ovaries, peritoneum and bowels.

Medications (stepwise treatments):

Step 1

  • Tab. Dolokind MR (Aceclofenac 100 mg, Paracetamol 325 mg, Chlorzoxazone 250 mg) – one tablet twice a day for 3 days.
  • Tab. Ovral L (Ethinyl estradiol 0.03 mg, Levonorgestrel 0.15 mg) – for 3 months. Ensure pregnancy is ruled out before starting Ovral L. For more information see below.

Step 2

  • Inj. Lupride Depot 3.75 (Luprolide 3.75 mg) – intramuscularly once a month for up to 6 months.
  • Tab. Gynaset 5 (Norethisterone 5 mg) – one tablet a day for up to 6 months.

Step 3

  • Laser ablation of endometriotic deposits
  • Chocolate cyst excision if needed
  • Hysterectomy in severe cases resistant to medical management

Supportive treatments:

  • Tab. Evecare Forte (Herbal remedy) – one tablet twice a day for 3 to 6 months.

General advice:

  • Drink plenty of fluids.
  • Applying heat pack or hot water bottle to lower abdomen and lower back may help.
  • Reduce strenuous activities during menstruation.

Investigations:

  • Transvaginal ultrasound – to identify extent of endometriosis and deposits.
  • Laparoscopy – to diagnose intraperitoneal deposits

Referral:

Consider referrial to gynaecologist if patient fails to respond or presents with additional complications.

Safe use of oral contraceptive pill (OCP):

  • OCP can be given safely if LMP was within last 5 days.
  • If LMP more than 5 days ago – ensure pregnancy has been ruled out i-can pregnancy test kit (urine pregnancy test) – Till then offer counselling and emergency contraception.