How is Endometriosis Diagnosed?

While many individuals experience the more common symptoms of endometriosis, a large proportion of people with the condition either have no symptoms or experience atypical symptoms, making it difficult for doctors to suspect endometriosis and delay a diagnosis.

A diagnosis of endometriosis often takes up to 7 – 10 years from the onset of symptoms. This is because of a combination of a lack of awareness and inexperience of doctors in primary care, the normalization of endometriosis pain as “part of being a woman”, and the lack of a straightforward and precise way of diagnosing it.

In light of the difficulty in diagnosing endometriosis, early detection is key to reducing the long-term impacts on patients’ health and improving their quality of life.

Steps to Diagnosing Endometriosis

1) History and Physical Examination

A careful history and examination by a trained physician can suggest the presence of the disease. Stage 1 or mild endometriosis usually cannot be felt on examination, however in more advanced stages, when there are larger growths or cysts, endometriosis can be detected during a gynecological assessment.

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2) Imaging Endometriosis

a) Ultrasound

Ultrasound is typically used to image pelvic structures because it is excellent at visualizing the uterus and ovaries and is easy to access for both patients and physicians.

Using ultrasound to assess endometriosis does require some advanced and very specific training; not all technicians have the specialized training required to be able to detect endometriosis. Ultrasound can identify endometriosis in cases where there are cysts (endometriomas) on one or both ovaries, large, deep growths, and when the condition has caused adhesions or scarring. However, less severe endometriotic growths are not visible on ultrasound.

b) Magnetic Resonance Imaging (MRI)

Another useful visualization tool for endometriosis is magnetic resonance imaging (MRI). Like ultrasound, it does not show the less severe growths but can be very useful in the assessments of more severe forms of endometriosis. MRI is effective in showing ovarian cysts or growths affecting the vagina, rectum, or bladder. It is also useful to diagnose endometriosis outside of the pelvis such as in the lungs or diaphragm.

MRI also requires extensive training and experience for the technologist and is still currently more expensive and less available than ultrasound.

3) BLOOD TESTS

Much research into a simple, non-invasive blood test has been done for endometriosis. Unfortunately, to date, there is no reliable blood test established to diagnose endometriosis.

4) LAPAROSCOPY

The best way to get a diagnosis of endometriosis is to have a laparoscopy, also known as a keyhole surgery. This process involves a small incision in your abdomen and the insertion of a small camera to check for endometriotic growths or cysts. The surgeon can then also take small samples of the tissue if growths are found.

The advantage of a laparoscopy is that it is not only diagnostic but can also become part of the treatment for endometriosis. All growths seen during the procedure can be removed. This will help reduce the symptoms experienced by the patient.