It can take many years after symptoms start to achieve an endometriosis diagnosis. Diagnosis delays are often the result of patients not seeking help. This normalisation of chronic period pain in which patients are conditioned to suffer pain in silence is one of the most common causes, particularly in younger people with the condition.
The similarity of endometriosis symptoms to other conditions also causes diagnosis delays. Endometriosis is often mistaken for irritable bowel syndrome, adenomyosis, endometrial polyps or pelvic inflammatory disease.
Severe pain should never be ignored, and it’s important you let your GP know about your symptoms. Provide them with as much information as possible by tracking your symptoms during your menstrual cycle. You can also ask your GP to refer you to the Julia Argyrou Endometriosis Centre at Epworth. A gynaecologist will be able to investigate further.
A pelvic exam is when a doctor manually examines the inside of the pelvis through the vagina. During a pelvic exam, a doctor may be able to feel ovarian cysts, scar tissue or other types of endometriosis lesions. Lesions are hard to find during a pelvic exam, but they can indicate that you have endometriosis.
A pelvic exam is undertaken with your consent and only if you feel comfortable.
Ultrasounds are the most effective imaging technique for detecting endometriosis. It involves creating high-quality images of the pelvic organs by placing a transducer (probe) inside the vagina. It creates images of your internal organs using sound waves.
Ultrasound images can show ovarian cysts, pelvic organs sticking together, or thickened uterosacral ligaments. They can also show cysts of endometriosis, called endometriomas. These are all signs of endometriosis. An ultrasound alone is often not enough to confirm you have endometriosis. A normal ultrasound does not mean that you do not have endometriosis.
Magnetic resonance imaging (MRI)
MRI uses a magnetic field and radiofrequency waves to generate detailed, cross-sectional images of your organs and other tissues. An MRI can help detect deep filtrating endometriosis, cysts on your ovaries, and lesions on your pelvis, bowel, and bladder. It can’t confirm endometriosis is present, but it can highlight a need for further investigation.
MRIs are also used in cases of severe endometriosis with bowel involvement or in people who cannot have an ultrasound through the vagina.
LaparoscopyLaparoscopic surgery is a minimally invasive (keyhole) procedure. It allows your surgeon to look inside your pelvic and abdominal cavities. A laparoscopy is usually recommended for patients suspected of having endometriosis. It is also used to see if endometriosis has returned. A laparoscopy is the only way to positively confirm endometriosis.