How We Diagnose Endometriosis
To diagnose endometriosis and other conditions that can cause pelvic pain, your doctor will ask you to describe your symptoms, including the location of your pain and when it occurs.
Tests to check for physical clues of endometriosis include:
- Pelvic exam. During a pelvic exam, your doctor manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often it’s not possible to feel small areas of endometriosis, unless they’ve caused a cyst to form.
- Ultrasound. During a vaginal ultrasound, a wand-shaped scanner (transducer) is inserted into your vagina. In an ultrasound of the pelvis via the abdomen, a small scanner is moved across your abdomen. Both tests use sound waves to provide a video image of your reproductive organs. Ultrasound imaging won’t definitively tell your doctor whether you have endometriosis, but it is a useful tool for identifying cysts associated with endometriosis (endometriomas).
- Laparoscopy. The only way for your doctor to know for certain that you have endometriosis is by looking inside your abdomen (direct visualization) for signs of endometrial implants. Commonly, this is accomplished during a minor surgical procedure called laparoscopy.
You receive a general anesthetic before the procedure begins. Using a special needle, your surgeon expands (distends) your abdomen with carbon dioxide gas so that the reproductive organs are easier to see. A tiny incision is made near your navel, and a slender viewing instrument (laparoscope) is inserted. By moving the laparoscope around, your surgeon can view the pelvic and other abdominal organs, looking for signs of endometrial tissue outside the uterus.
If you have endometriosis, laparoscopy will provide you and your doctor with information about the location, extent and size of the endometrial implants. This information will help your doctor guide you through treatment options.