How is Endometriosis diagnosed?
What can I do to help?
Diagnosing Endometriosis can be considerably challenging due an alarming and unacceptable delay, averaging 8 years, between the onset of symptoms and a diagnosis. To make matters more challenging, there is currently no reliable or straightforward test available for detecting Endometriosis. Complicating matters further, the understanding of symptoms and risk factors are not that well understood.
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The symptoms can also be similar to those of several other health conditions, such as Irritable Bowel Syndrome, Acute Appendicitis or Crohn’s disease, often make it difficult for doctors to diagnose Endometriosis.
To make matters more challenging, many of these other conditions can also co-exist with Endometriosis.
What can I do to help?
Keeping a symptom diary can not only help you think about your symptoms, possible triggers and how often they occur, but it can also help towards getting you the care and support you need, as well as a diagnosis.
It can also help when having conversations with health care professionals about your treatment choices and what treatments help you, as well as supporting you through your treatment plans.
When should I seek help?
If you’re experiencing period related pain or pelvic pain outside of your period that is affecting your day-to-day activities like attending school, work or interfering with your social life, or if you have noticed changes around your menstrual cycle, this could be a sign of Endometriosis, or it might be related to something else.
At this point it is important to make an appointment and discuss this with your GP.
Some of these symptoms may not have an underlying cause and not everyone who has pain will have Endometriosis. Nonetheless, it is important to determine if there is anything causing them, as well as possible treatments regardless of the cause.
Suspected Endometriosis diagnosis
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Your doctor can suspect Endometriosis based on your symptoms, and other factors such as family history, and investigations; this is providing that all other potential causes are ruled out. These investigations may involve feeling your tummy and pelvis (external exam) and where appropriate, they may also include a pelvic exam (internal examination).
Your doctor may suggest further investigations to help reach a diagnosis. The first of these is usually a pelvic ultrasound scan, which is best performed internally, but can be carried out through the outside of the tummy.
Ultrasound can be particularly helpful to look for physical signs of Endometriosis, cysts in the ovaries, and to also rule out other potential causes. It is important to note that Endometriosis is not always seen on scans. If your results return clear, this does not mean you don’t have Endometriosis. This should not prevent you from continuing to seek further investigations and treatment.
You can try medical treatments and holistic therapies without a confirmed diagnosis and have investigations if they do not help.
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Surgical diagnosis
At present, the only way to definitively diagnose Endometriosis is by undergoing laparoscopic (keyhole) surgery. This is an invasive procedure. If your symptoms are severe or if your doctor suspects you have Endometriosis and you decide surgery is right for you, your gynaecologist will perform the laparoscopy to look for Endometriosis, they may also treat it during your diagnostic laparoscopy or schedule a second operation.
A history of symptoms, a pelvic exam, ultrasound scan and MRI may help highlight the likelihood of Endometriosis, however laparoscopic surgery is currently the only way to conclusively diagnose the condition.
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It’s important to know.
Endometriosis is a complex condition; therefore diagnosis and treatment are best carried out by a gynaecologist with a specialist interest in Endometriosis. This is because not all gynaecologists are familiar with Endometriosis. Furthermore, not all surgeons are trained specifically in diagnosing and treating the condition.
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