Endometriosis: symptoms and diagnosis
This information aims to provide patients with an overview of the symptoms and diagnosis of endometriosis.
Endometriosis is a condition where the endometrial cells lining the womb stick to other parts of the body forming endometriosis lesions, most commonly to the inside lining of the pelvis and the ovaries
Endometriosis is a common, chronic and debilitating condition that occurs in women of reproductive age (from adolescence to menopause). It is associated with the following symptoms:
- Dysmenorrhoea (painful periods)
- Pelvic pain (which may not be during a period)
- Dyspareunia (painful intercourse/sex)
- Lower back pain
- Ovulation pain
- Painful bowel movements
- Bladder symptoms
- Heavy bleeding
- Persistent fatigue
Endometriosis can also be associated with difficulties becoming pregnant, but even women with severe endometriosis can still have a baby naturally. It is estimated that 60-70% of women with endometriosis are fertile and can get pregnant spontaneously and have children.Of the women with fertility problems, a proportion will get pregnant, but only after medical assistance - either surgery with removal of the endometriosis lesions or medically assisted reproduction (IVF).
Endometriosis can co-exist with adhesions which may also play a role in infertility or sub-fertility.
You should consult your GP if you have these symptoms and are concerned that you have endometriosis.
The only definitive way to diagnose endometriosis is by a laparoscopy- an operation in which a camera is inserted into the pelvis via a small cut near the tummy button. The surgeon uses the camera to see the pelvic organs and look for any signs of endometriosis. If endometriosis is diagnosed, the endometriosis may be treated or removed at the same time. A laparoscopy is usually a straightforward day case procedure but it carries a risk of major complications, such as bowel, bladder or blood vessel damage of between one and two for each 1,000 procedures. (RCOG Guideline)
Scans and blood tests are not a conclusive way to diagnose endometriosis, and a normal scan and blood test does not mean that you do not have endometriosis.
An MRI scan (magnetic resonance imaging) of your pelvis can be helpful for identifying deep endometriosis and adenomyosis. Adenomyosis inside the muscle wall of the womb is not visible during a diagnostic laparoscopy.
Some gynaecologists have more knowledge of and experience in the area of endometriosis than others. You may want to find out about the situation regarding referral in your area and look for a BSGE accredited centre for endometriosis http://bsge.org.uk/ec-BSGE-accredited-centres.php.
Issue date: February 2012
Update: May 2015
Review date: May 2018
Article: Endometriosis is simple
Ask questions about endometriosis here.
Endometriosis and Pelvic Pain by Dr Susan Evans in 3 parts (please follow link below)
Part 1 - What it is, the symptoms and how it is diagnosed, Part 2 - Painful periods, sharp, stabbing pains ,
Part 3 - Irritable bowel syndrome, headaches
Please click here.
To read about the causes of Endometriosis click here.