If you’ve been experiencing pelvic pain, painful periods, or difficulty conceiving, you may suspect that something is wrong, but it can be difficult to pinpoint the cause. Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus, and it affects 1 in 10 women during their reproductive years. However, diagnosing endometriosis can be tricky because its symptoms often overlap with other conditions, and there isn’t one single test to confirm it.
In this article, we’ll explain how endometriosis is diagnosed, from recognizing symptoms to undergoing tests and surgery. We’ll walk you through the process of getting an accurate diagnosis so you can take the next step toward effective treatment.
What Is Endometriosis and How Does It Affect the Body?
Endometriosis occurs when endometrial-like tissue (the tissue that normally lines the inside of your uterus) grows outside the uterus, typically on the ovaries, fallopian tubes, or the outer surface of the uterus. This tissue behaves the same way as the uterus lining: it thickens, breaks down, and bleeds every month, but unlike the uterine lining, there’s no way for the blood to exit the body. This causes inflammation and pain and can result in the formation of scar tissue and adhesions (abnormal tissue binding organs together).
The presence of this tissue in areas outside the uterus can affect nearby organs and tissues, causing pelvic pain, painful periods, infertility, and sometimes even digestive problems. However, the severity of symptoms varies from person to person.
Key Symptoms:
- Painful periods (dysmenorrhea)
- Pain during intercourse
- Heavy menstrual bleeding
- Pain with bowel movements or urination
- Infertility
Step 1: Recognizing the Symptoms
The first step toward diagnosing endometriosis is recognising its symptoms, which can sometimes be mistaken for other conditions, such as irritable bowel syndrome (IBS) or pelvic inflammatory disease (PID). The most common symptoms to watch for include:
1. Pelvic Pain
Pelvic pain is the hallmark symptom of endometriosis. It’s often described as cramping or a deep ache in the pelvic region that may get worse during menstruation.
2. Painful Periods
Although painful periods are common for many women, if the pain is debilitating and doesn’t improve with over-the-counter pain medications, it could be a sign of endometriosis.
3. Painful Intercourse
Many women with endometriosis experience pain during or after intercourse, particularly during deep penetration.
4. Infertility
Endometriosis is one of the leading causes of female infertility. Women with this condition may find it difficult to get pregnant due to the effects of scar tissue or blockages in the reproductive organs.
5. Gastrointestinal Issues
Endometriosis can cause symptoms that mimic IBS, including bloating, diarrhoea, constipation, and painful bowel movements, especially during menstruation.
Step 2: Initial Examination and Medical History
Once you’ve identified potential symptoms, it’s essential to consult with a healthcare provider. A gynaecologist or obstetrician will review your medical history and ask about your symptoms. You’ll likely be asked to provide detailed information about your menstrual cycle, pain levels, and any difficulty with fertility.
Physical Examination:
The doctor may perform a pelvic exam to check for signs of pain, cysts, or abnormal tissue in the pelvic region. While a pelvic exam can’t definitively diagnose endometriosis, it can help identify areas of tenderness and ovarian cysts (known as endometriomas) that are sometimes associated with the condition.
Step 3: Imaging Tests for Diagnosis
In some cases, imaging tests like ultrasound or MRI may be used to help diagnose endometriosis. While these tests can help detect ovarian cysts or endometrial-like tissue, they cannot definitively diagnose endometriosis. However, they can help rule out other conditions and give the doctor more information about your reproductive health.
1. Ultrasound
A pelvic ultrasound is a non-invasive imaging test that uses sound waves to create an image of your pelvic organs. Endometriomas (cysts caused by endometriosis) may be visible on an ultrasound, but small implants or lesions typically won’t show up.
2. Magnetic Resonance Imaging (MRI)
An MRI may be used to get a more detailed image of the pelvic area. This can help identify the extent of the disease, especially if the endometrial tissue is affecting deeper structures like the bowel or bladder.
Step 4: Laparoscopy—The Gold Standard for Diagnosis
While ultrasound and MRI can offer clues, the only way to definitively diagnose endometriosis is through laparoscopy, a minimally invasive surgical procedure. During a laparoscopy, a small camera is inserted into the pelvic cavity through a small incision in the abdomen, allowing the doctor to visualize the endometrial tissue directly.
What Happens During Laparoscopy:
- The procedure is done under general anaesthesia.
- The doctor makes a small incision near the belly button and inserts a laparoscope (a thin tube with a camera).
- The surgeon can view the pelvic organs and may take biopsies (samples of tissue) to confirm the diagnosis.
Benefits of Laparoscopy:
- Accurate diagnosis: It’s the gold standard for diagnosing endometriosis and its severity.
- Treatment option: The surgeon may also use laparoscopy to remove or destroy endometrial tissue, adhesions, and cysts, improving symptoms and fertility.
Step 5: Other Tests to Rule Out Other Conditions
Because endometriosis shares symptoms with other conditions, your doctor may also perform tests to rule out other potential causes of your symptoms, such as pelvic inflammatory disease (PID), irritable bowel syndrome (IBS), or ovarian cysts.
1. Blood Tests
Although there are no specific blood tests for endometriosis, doctors may use tests like CA-125 (a cancer antigen) to measure inflammation. However, CA-125 levels can also be elevated in other conditions, so it’s not a definitive test for endometriosis.
Final Thoughts
Diagnosing endometriosis is a multi-step process that begins with recognizing the symptoms and consulting with a healthcare provider. A combination of a thorough medical history, physical exams, and imaging tests can help point toward endometriosis, but laparoscopy remains the gold standard for an accurate diagnosis. Early diagnosis and treatment are essential for managing the symptoms of endometriosis and improving fertility outcomes.
If you’re experiencing symptoms of endometriosis, don’t wait. Consult a specialist to get the proper diagnosis and start the journey to effective treatment.
Sources:
Anna Haotanto is the Founder of Zora Health and a passionate advocate for women’s empowerment. Anna’s personal experiences with egg-freezing, PCOS, perimenopause and the challenges of fertility have fueled her mission to provide high-quality information, financing, and support to help women and couples navigate their fertility journeys with confidence. She is also recognised for her achievements in finance, entrepreneurship, and women’s empowerment, and has been featured in various media outlets. You can also follow her on Linkedin or Instagram.
