Endometriosis Care & Services

Our team of senior, tertiary, female OB/GYNs are passionate about identifying endometriosis and providing endometriosis care & treatment for a condition that causes so many women a distressing set of symptoms.

Endometriosis is one of the commonest conditions affecting women of reproductive age and often associated with chronic and severe pelvic and abdominal pain, heavy menstrual flow, long periods, gastrointestinal issues, fatigue, and infertility. But there is much that can be done and our team provides sensitive and holistic endometriosis care, diagnosis and treatment.

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Why Choose our Team?

All-female team of senior OB/GYN doctors

Dedicated, private & relaxing Women’s Health Suite

Highly experienced, tertiary consultant, multidisciplinary team


What is Endometriosis Care?

Firstly, let’s discuss endometriosis. Endometriosis is a common gynaecological disorder thought to affect up to 10% of reproductive-aged women worldwide. In people with endometriosis, tissue that normally lines the inside of the uterus (the endometrium) starts to grow in other parts of the reproductive system. Endometriosis most commonly affects the ovaries, fallopian tubes, and tissues lining the pelvis. 

Endometriosis is a chronic and often debilitating disease that can cause severe pelvic pain and menstrual cramps, nausea, and fatigue. The condition may lead to other serious conditions such as depression, anxiety, and infertility.

Presently, there is no known absolute cure for endometriosis. So, endometriosis care centres around medical and surgical treatments to manage the symptoms of the condition. The most suitable treatments options for endometriosis vary a lot from one person to the next and often depend on which symptoms need addressing. Having first confirmed endometriosis, our team of experienced endometriosis doctors will discuss your symptoms before you progress with any form of treatment, so that we can develop an approach and options best suited to you as an individual.


Our Endometriosis Care & Services

Because there is no known outright cure for endometriosis, our endometriosis care in Cayman, is predominantly focused on alleviating the symptoms of the disease. Suitable treatment options can vary a lot between patients, and will depend on the symptoms, degree, and stage of your condition. We will always want to ensure that an endometriosis care plan is developed around you personally. Possible treatment options for endometriosis include pain medication, hormone therapy and sometimes surgery.

Additionally, both Dr Lisa Joels, OBGYN and Dr Madhavi Manoharan, OBGYN, both highly experienced in all aspects of endometriosis care, will also want to evaluate the more holistic approaches that may be useful and sometimes even preferable. These can include certain lifestyle changes to relieve the symptoms of endometriosis, such as:

  • Eating a healthy diet
  • Avoiding or limiting alcohol and caffeine
  • Regular exercise
  • Stress management

The most important aspect of endometriosis care for us is to recognise that every patient is unique, and therefore to work with you to develop options suited to your expression of endometriosis and your treatment and lifestyle goals.

Risk Factors for Endometriosis

Although the precise causes of endometriosis are still somewhat of a mystery, studies have identified certain factors that put women at greater risk of developing the condition. Risk factors for endometriosis include having a direct female relative (i.e., mother, sister, or daughter) with the disease, starting your period at an early age (i.e., before age 11), having a short menstrual cycle (i.e., shorter than 27 days), having excessively heavy periods that last longer than 7 days, being infertile and having a low body mass index. If you have some of these risk factors and symptoms, it is worth making an appointment to see either Dr Lisa Joels or Dr Madhavi Manoharan.

Endometriosis Care & Monitoring

Besides direct endometriosis care and attention to symptoms, we also recognise that symptom severity can vary from time to time and the disease itself can progress at different stages, our endometriosis team will discuss with you want might constitute an appropriate monitoring and follow up regimen, suited to your everyday life and balancing self-management with time at the doctors! We will also advise if there are any regular checks that need to be performed e.g. annually.


Common Symptoms of Endometriosis

Endometriosis is often characterised by severe pelvic pain, but some people with the disorder may experience little or no pain. It is important to note that the degree of pain does not indicate the severity of the condition, and there of several other signs and symptoms of endometriosis to watch out for, including:

  • Excessively painful menstrual cramps
  • Menstrual cramps 1 or 2 weeks around the time of your period
  • Heavy bleeding during periods
  • Bleeding between periods
  • Pain during sex
  • Pain or discomfort during bowel movements
  • Pain or discomfort during urination
  • Other gastrointestinal problems during periods (e.g. constipation, diarrhea, nausea, bloating)
  • Lower back pain that may occur at any point of your menstrual cycle
  • Infertility

Despite being one of the most common diseases among girls and women, endometriosis frequently goes undiagnosed. As abdominal pain is one of the main symptoms associated with the condition, women’s symptoms are often mistaken for those of normal menstruation, and their concerns dismissed. For instance, on average, a woman in the United States will wait 10 years for a formal diagnosis of endometriosis.


Dr Lisa Joels

Obstetrician & Gynaecologist
Tel: +1 (345) 745 7450 (clinic)
Email: [email protected]

Dr Joels has 36 years’ experience in obstetrics and gynaecology including 19 years as a Consultant working in Swansea (2001-11) and subsequently at the Royal Devon & Exeter NHS Foundations Trust in the UK (2011-20). She was lead clinician for prestigious Fertility Exeter and is passionate about women-centred care.


  • Obstetric Services (Pregnancy)
  • High-Risk Obstetric Service
  • Fertility Services
  • Gynaecology Care & Surgery
  • Paediatric & Adolescent Gynaecology

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Dr Madhavi Manoharan

Obstetrician & Gynaecologist
Tel: +1 (345) 745 7450 (clinic)
Email: [email protected]

Dr Manoharan has 23 years’ experience in obstetrics and gynaecology, including more than a decade at tertiary level, 7 years as consultant at the prestigious Royal Free London NHS Foundation Trust and a number of years as Assistant Professor at the world-renowned Weil Cornell Medicine, located in their Qatar campus, part of Cornell University.


  • Obstetric Services (Pregnancy)
  • High-Risk Obstetric Service
  • Fetal-Maternal Medicine
  • Gynaecology Care & Surgery
  • Coloposcopy (Accredited)

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Clinic Location & Open Times

The Grand Pavilion Commercial Centre, Hibiscus Way, 802 West Bay Road.

  • Monday to Friday: 8.30am first appointment, 4.30pm last appointment
  • Saturday: 8.30am first appointment, 12.30pm last appointment

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