From symptoms to answers: how endometriosis is diagnosed

Period pain is common. More than half of women experience some pain when they menstruate each month. But if your period is severely painful, or you have pain during sex or when you use the bathroom, it may suggest endometriosis.

Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus as lesions. It affects about 10 percent of women of childbearing age. Diagnosing endometriosis may take up to a decade, meaning an affected person can live with pain for years.

But relief is possible—and it starts with getting an accurate diagnosis. Here’s what you can do.

Visit a healthcare provider

In many cases, endometriosis presents with no symptoms at all, including pain. A person may learn they have endometriosis when they have a separate medical procedure, or when they’re unable to become pregnant. Nearly 40 percent of women with infertility also have endometriosis.

But if you are experiencing painful symptoms that could suggest the condition, it’s important to make an appointment with an OBGYN. When you show up for your visit, they will take your medical history, perform a physical exam, and may draw blood to rule out other conditions.

Be ready to discuss any period-related symptoms with the OBGYN. It may help to prepare answers for the following questions.

• What are your symptoms? How severe are they?
• Before, during, or after your periods, do you experience pelvic pain, discomfort with bowel movements or urination, or lower back pain?
• Is sex painful or uncomfortable for you?
• Are you experiencing heavy periods or spotting between periods?
• When did you start noticing these symptoms and are they worsening with time?

During the visit, the OBGYN will perform a pelvic exam. You’ll undress, put on a patient gown, and lie down on an examination table with your feet placed in stirrups. This position allows the OBGYN to visually inspect and palpate (examine by touch) your reproductive organs, namely the vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. The inside of your lower abdomen will be examined for any abnormalities such as lesions, cysts, growths, or scars.

While uncomfortable for some, pelvic exams typically last just a few minutes. If you feel anxious or have a past trauma or history of sexual violence, let your OBGYN know beforehand so they can accommodate your needs.

Next steps in diagnosis

Depending on the findings or at your OBGYN’s discretion, a diagnostic imaging technique such as an ultrasound, CT scan, or MRI may be ordered. While these techniques may help confirm findings from a pelvic exam, they cannot distinguish endometriosis from other conditions.

The only way to definitively diagnose endometriosis is with a minor surgical procedure called laparoscopy. It’s usually performed under general anesthesia, so you’ll be asleep when it happens.

During a laparoscopy, an OBGYN will insert a thin tube with a tiny camera and light at the end (a laparoscope), into your abdomen through a small incision. This will allow them to examine organs in the pelvic cavity to determine the location, size, and shape of endometriosis lesions, cysts, or scars. The OBGYN may remove the lesions or take a small tissue sample, called a biopsy, to examine under a microscope. If endometriosis is confirmed, treatment can begin.

Importance of diagnosis

Some people assume endometriosis is part of having a normal period, while others don’t receive an accurate diagnosis because symptoms tend to mimic other diseases. This can lead to years of pain, when treatment is available.

Remember: You know your body best, so speak up. Talk to a healthcare provider if you have unusual, severe, or new symptoms—especially pain—or if you suspect you might have endometriosis. The faster you begin the process, the faster you can get relief.