Q: I am a 29 years old female who underwent laparoscopy for endometriotic cyst almost two years back. After one year, I felt severe pain on my lower right abdomen and the back. Then, I was asked to undergo treatment i.e. Gynazol (200 mg) once a day for four months. My doctor told me that the cyst, which had developed on the right side had reduced and I stopped the medicine. After two months, the problem recurred. She advised me to take Lupride depot injection with Danazol (200 mg). Please advise.

A:Endometriotic cyst usually is associated with deep infiltrating endometriosis, which can give problems such as pain during sexual intercourse, pain during opening bowels, constant low backache and pain during periods. If you have these symptoms it does suggest that you have severe endometriosis.

The best way to deal with endometriosis is excising it (removing it). This can be done effectively by laparoscope but the surgeon needs expertise in doing it. Not all gynaecologists are trained to do these operations. Hormonal preparations which you are currently taking will help in controlling symptoms to some extent but are not a definitive cure. They also can give you quite unpleasant side-effects such as dry vagina, hot flushes, pain in breasts, etc. In the long-term they may give osteoporosis (which may make bones weak). I therefore advise you to undergo surgery (with gynaecologist experienced in operating on deep infiltrating endometriosis) and not to take medication as a long term solution.