Endometriosis is a common condition, but it’s often hard to diagnose. The symptoms can vary widely, and some people might not even realize they have had them for years. Understanding how to test for endometriosis may put you on the path to a diagnosis.
If you have unexplained pelvic pain, heavy periods or trouble getting pregnant, make an appointment with your gynecologist. They can check if endometriosis is the cause.
What is endometriosis?
Endometriosis occurs when tissue similar to the lining of your uterus (the endometrium) grows outside it. This tissue can attach to other organs like your ovaries, fallopian tubes or the tissue lining your pelvis.
Each month, this tissue responds to the hormonal changes in your cycle, but unlike the tissue inside the uterus, it has nowhere to go. This leads to inflammation, pain and sometimes scarring or adhesions.
Why is it so hard to diagnose?
Endometriosis can be tricky to diagnose because its symptoms often overlap with other conditions. Symptoms of endometriosis, such as painful periods, pelvic pain and digestive issues, can also be signs of other health problems, like irritable bowel syndrome (IBS) or pelvic inflammatory disease (PID). Some people with endometriosis may not even experience noticeable symptoms, making it harder to catch early.
Additionally, there’s no single test that definitively diagnoses endometriosis. Instead, doctors often rely on a combination of medical history, physical exams, imaging tests and sometimes surgery to make a diagnosis.
How to test for endometriosis
If you think you might have endometriosis, talk to your doctor about your symptoms. Getting a diagnosis of endometriosis includes several steps.
A detailed discussion of your symptoms
The first thing your doctor will likely do is ask you about your symptoms. Explain your menstrual cycle, whether you experience pelvic pain, pain during sex or problems with digestion.
Be honest and detailed – the more information you provide, the better your doctor will understand your situation.
A physical exam
Your doctor will perform a pelvic exam to check for any abnormalities in your reproductive organs. During this exam, they may press on your abdomen or pelvis to see if you feel any pain.
A pelvic exam can sometimes help identify cysts or scars from endometriosis. However, it’s not always effective because the tissue may be deep inside your body, making it hard to feel.
Imaging tests
Imaging tests, like ultrasounds or MRIs, can be used to get a better look at your reproductive organs. However, while these tests help detect large cysts or endometriosis growths on the ovaries, they can’t definitively diagnose endometriosis.
Many people with the condition don’t show any obvious signs on imaging, so these tests are typically used to rule out other possible conditions.
- Ultrasound is often the first imaging test doctors use. It uses sound waves to create an image of your pelvic organs. An ultrasound can sometimes detect ovarian endometriomas, which are cysts that form on the ovaries due to endometriosis.
- MRI can provide more detailed images of the pelvic organs. These images may help doctors assess the size and location of endometriosis growths, especially if the condition is more severe.
While both of these imaging tests are useful, neither is perfect. They can give clues but can’t confirm the presence of endometriosis on their own.
Laparoscopic surgery
The only way to definitively diagnose endometriosis is through a procedure called laparoscopy. This is a minimally invasive surgical procedure where a doctor makes a small cut in your abdomen and inserts a camera (laparoscope) to directly view the tissue inside your pelvic cavity.
During this procedure, your doctor can look for endometriosis growths, adhesions and cysts. They may also take tissue samples (biopsies) to confirm the diagnosis. Doctors consider laparoscopy as the gold standard for diagnosing endometriosis because it allows doctors to directly see the condition and assess its severity.
Doctors typically perform laparoscopy under general anesthesia, so you’ll be asleep during the procedure. While it is considered safe, it is still surgery, so it carries some risks, like any procedure that requires incisions. However, it’s often the best option when other tests are inconclusive, or your doctor needs to assess the extent of your condition.
Other tests and considerations
While laparoscopy is the most reliable way to diagnose endometriosis, some doctors may suggest other tests or assessments depending on your situation. For instance:
- Blood tests: While no blood test can directly diagnose endometriosis, certain tests can help rule out other conditions, such as infections or hormonal imbalances, that might cause similar symptoms.
- Fertility tests: If you are having difficulty getting pregnant and your doctor suspects endometriosis, they may do fertility tests to assess any potential impact on your reproductive organs.
What happens after diagnosis?
If your doctor diagnoses you with endometriosis, they’ll discuss treatment options with you based on the severity and your symptoms.
Treatment for endometriosis may include pain management, hormonal therapies to control the growth of endometrial tissue or even surgery to remove the tissue. In some cases, people with severe endometriosis may need a hysterectomy, though this is often a last resort.
How we can help
Endometriosis can be challenging to diagnose because its symptoms overlap with so many other conditions. However, understanding how to test for endometriosis can help you start the process. Getting a diagnosis earlier can make it easier to manage your condition.
If you’re dealing with chronic pelvic pain or other symptoms, make an appointment with your gynecologist. They can guide you through the process and help you find a treatment plan that works best for you.
Learn about the gynecology and women’s health services we offer at Mercy Health.
