Diagnosis

There is a significant diagnostic delay of endometriosis because symptoms of the disease are not easily recognised in primary care – or even by women themselves.

Endometriosis can only be diagnosed via laparoscopy with “visual inspection” unless disease is visable in the vagina or elsewhere [1] – but the surgeon performing this procedure needs to know what s/he is looking for [2] – in fact: the incidence of the diagnosis of endometriosis is down to the curiosity of the surgeon and the pathologist who examines the biopsy.

Today there is no simple test that can be used to diagnose endometriosis, which may be why there is a diagnostic delay of up to 12 years in some healthcare settings.

At present the only reliable way to definitively diagnose endometriosis is by performing a laparoscopy and to take a biopsy of the tissue. This is what is known as “the gold standard”.

However, this is an expensive, invasive procedure. Furthermore, if the surgeon is not a specialist in endometriosis s/he may not recognise the disease, which can result in a “negative”result (ie. you may be told that you have not got endometriosis, even if you do, because the surgeon was unable to visually recognise the disease, and if no biopsy was taken). And, not everyone want to have surgery.

This makes diagnosing endometriosis a challenge, and therefore an experienced gynaecologist should be able to recognise symptoms suggestive of endometriosis through talking with the woman and obtain a history of her symptoms. For this to be effective, it is important that the woman is honest with her physician about all of her symptoms and the pattern of these.

If YOU want to discuss your symptoms with a physician you can prepare for this consultation by using this downloadable aid. It highlights the questions your doctor may ask you:

» Your first consultation

Fill in the questions, talk these through with your doctor and, by assisting her/him in assessing your symptoms and responses, you can, together, decide on the right treatment plan for you.

» How to find a specialist in endometriosis | 10 things to consider about your treatment

Tests for endometriosis?

There are tests, which the gynaecologist may perform. These include:

Ultrasound
MRI scans
CA125
Gynaecological examinations.

None of these can definitively confirm endometriosis (though they can be suggestive of the disease), nor can they definitively dismiss the presence of endometriotic lesions/cysts.

The fact that there is no non-invasive, definitive diagnostic method for endometriosis is as frustrating for clinicians as it is for women with the disease.