Q: I am seeking advice for my fiancee who suffers from endometriosis. Last year she had undergone a surgery because the doctors found the size of the cyst to be considerably large. As per doctors advice she took medicines for 6 months. Her recent ultrasound showed a small cyst in the ovary again. The doctor has advised not to use contraceptive pills after marriage. Moreover, he said that once she conceives, the disease will get cured automatically. Could you please reply our following queries: 1.Why has the cyst started developing again. She has started taking medicines again and has been advised to continue till we get married. Is it OK? 2.Will she be OK once she conceives? Also, will she be able to conceive and deliver a child easily or would it pose any additional risk? 3.After marriage, do we need to take any extra precautions regarding our sex life?

A:The cyst you can see on ultrasound can be a residual cyst (as the whole ovary would not have been removed in a young lady) i.e. a part of the cyst may be left. Or it may be a new cyst in the same ovary. Also a growing egg in the ovary may look like a cyst. The doctors will assess that and let you know. Why a new cyst appears is the natural progression of the disease and will happen throughout but at an unpredictable pace (very slow to reasonably fast) depending upon the individual. 2. Pregnancy is generally good for the disease but what difficulties she may or may not have will depend again on the individual. i.e. you can have ten children with endometriosis and you may not have one despite having no endometriosis. In fact we cannot say at this stage how the disease will behave in her case in the future. The problem may be in the form of menstrual problems and pain in the abdomen. 3. There should be no significant problems in having a normal married life. Any problems regarding sex will have to be treated individually and no precautions are required.