What is Involved in a Diagnosis of Endometriosis?

Endometriosis is a little-understood and often painful condition that affects women. Caused by the inflammation and abnormal growth of uterine tissue, this condition can cause severe pain and infertility if untreated. The diagnosis of endometriosis is often difficult, as symptoms may not always be present and may be masked by other issues. Obtaining a diagnosis often involves some testing as well as physical exams.

The condition results when uterine tissue grows outside the uterus, such as on the bowels or pelvic lining. The first symptom is severe menstrual cramps, which can be many times worse than regular menstrual cramping. Some women with endometriosis may not notice the condition for months or even years, but since the pain tends to worsen with the progression of endometriosis, many begin to seek treatment as pain increases. Other common symptoms include painful bowel movements, discomfort or pain during intercourse, and bleeding between periods.

The diagnosis of endometriosis often begins with a trip to a general gynecologist or doctor. Women may report difficulty getting pregnant, or any of the pain-related symptoms described above. Doctors may first perform a pelvic exam, which involves a manual examination of the pelvic region. This, unfortunately is rarely effective in obtaining a diagnosis of endometriosis, as the condition may only be noticeable if large cysts form in the pelvic area. A pelvic exam can be useful, however, in ruling out other possibilities such as a tumor or abnormal growth.

Some doctors may order an additional test called an ultrasound, which uses sound waves to produce a pictorial representation of the pelvic area, uterus, ovaries, and vaginal canal. This test is done in one of two ways: an external device that can produce images when moved across the pelvis, or an interior test that gets images from a tool inserted into the vagina. This test allows a better view of any cysts that may be growing inside the regions that are associated with the condition, but is often not enough to make a diagnosis of endometriosis.

Usually the final step in a diagnosis of endometriosis is laparoscopic surgery. Usually done under anesthesia, the minimally invasive procedure involves inserting a narrow instrument through a small incision in the pelvic region. The surgery is sometimes performed on an outpatient basis, though the patient will not be able to drive afterward. This test can give clear results as to weather the condition exists and what organs or systems it is harming. It can also show how much scar tissue is present from the condition, which may be reducing fertility or causing painful cramps.