How Is Endometriosis Diagnosed?
Endometriosis can be a very painful condition, which is why women should visit their doctors regularly. If endometriosis is discovered earlier, treatments can cost much less, and you will get rid of the disease much more easily. If not, the consequences can be severe. The symptoms of endometriosis can be mistaken for the symptoms of other illnesses, such as pelvic inflammatory disease or ovarian cysts. These diseases can cause pain, so an accurate diagnosis is required to determine the exact cause of your condition.
Endometriosis involves an abnormal growth of cells or endometrial tissues in a location outside of the uterus. During one’s menstruation cycle, the endometrial tissues are shed, and this happens every month. Endometriosis is mostly found on other organs or regions of the pelvic area. This condition is very commonly seen in women facing infertility issues, rather than in those women who are fertile. However, a point to note is that this condition does not necessarily cause infertility in a woman. Based on the exact location, the depth, and the extent of endometriosis implants, the endometriosis is divided into four different stages. These stages include minimal, mild, moderate, and severe endometriosis.
Who is at risk of getting endometriosis?
Women during their reproductive years are the ones mostly affected by endometriosis. It is also one of the major causes of pain in the pelvic region. Girls as young as 11 years of age are seen to be affected with endometriosis, even though the age group for this illness is typically in the bracket of 25 to 35 years of age. Certain factors, such as delaying pregnancy for a long period of time until one gets older, not allowing pregnancy to happen, menstruation cycle starting at an early age or late menopause, are seen as contributors of increasing risk of endometriosis.
Symptoms of Endometriosis
Most women do not experience any symptoms. However, if they do experience any symptoms, then it often gets confused with other illnesses. For those who do experience symptoms, below are few of the possible symptoms:
- During intercourse, one may experience cramps.
- While urinating or during bowel movements, one may experience cramping in that area.
- At times, it can also cause infertility.
- Sexual intercourse may be painful.
- Before menstruation, one may experience severe pain, which reduces gradually after menstruation.
The pain that a women experiences also varies from month to month. Some may come across a progressive worsening of symptoms, and others may get a resolution of pain without any treatment.
A few other symptoms, which are rare, however, one could experience are mentioned below:
- Fatigue may occur without doing any hard work, and this could turn out to be chronic fatigue.
- Pain in the lower back area without explanation.
- Pain in the lower abdominal area without explanation.
- Constipation or diarrhea without a cause.
- At times, the menstruation could become irregular.
- During menstruation, one may experience blood in the urine.
- A headache or a cold and a cough may occur.
- Convulsions may occur, although this is very rare.
Causes of endometriosis
There are various theories on proving the cause of endometriosis; however, the exact cause is still unknown. One of the theories says that the areas lining the pelvic organs contains primitive cells. These cells are able to develop and form other tissues, one of which is known as endometrium. Another theory states that the endometrial tissue gets deposited in unusual locations. This happens due to the retrograde flow of menstrual debris, which happens in the fallopian tubes. The exact cause of this retrograde menstruation is not known.
You would need to reach out to an obstetrician gynecologist when you face issues related to endometriosis.
Diagnosis of Endometriosis
Endometriosis can be assumed based on the symptoms and the physical examination done by the doctor. However, both cannot be completely relied upon; hence, certain diagnosis tests are required to get the same confirmed. One method of diagnosis is ultrasound, which helps the doctor in ruling out other diseases related to the pelvic region and suggests the presence of endometriosis.
The following diagnosis techniques are usually performed when you consult a gynecologist:
Patient's history
First, your doctor will ask about the symptoms that you are experiencing and then ask about a family history of endometriosis. The doctor may also conduct a general physical examination to know if there are signs of other disorders.
Pelvic exam
A pelvic examination is done manually. This means that the doctor will examine your abdomen by touching it with his fingers. If an abnormality can be found, it does not necessilaryly mean that you are suffering from endometriosis. In most cases, it is not possible to feel small areas of endometriosis, unless they have formed cysts.
Ultrasound
The ultrasound examination is a good way to tell if you have endometriosis. An ultrasound is a machine that creates sound waves to produce internal images of the body. The doctor may use either a transvaginal ultrasound or an abdominal ultrasound. In a transvaginal ultrasound, a transducer is inserted into a woman’s vagina. These two types of ultrasound show internal images of your reproductive organs. Ultrasound machines can help the doctor in finding cysts that are associated with endometriosis. However, an ultrasound report is not enough to rule out the disease.
Laparoscopy
Laparoscopy is the most common and most effective way to diagnose endometriosis. A laparoscopy is performed by a surgeon. During the procedure, a certain anesthetic will be administered to suppress the pain. The surgeon will surgically open your abdomen and inspect it with a laparoscope. If there are any visible signs of endometriosis, the doctor will diagnose it. If not, he/she will do a biopsy, and he/she will take a part of the tissue for further investigation.
These are some ways endometriosis can be diagnosed. Endometriosis is considered to be a common gynecological condition. If diagnosed, you are not the only one who is suffering from this condition. Consult a gynecologist as soon as you suspect endometriosis.
Treatment of Endometriosis
The treatment of endometriosis can be done either with medications or surgery; both options can be used, if needed. The doctor, when treating a patient with endometriosis, would focus either on getting rid of the symptoms to get some relief for the patient or avoiding infertility.
Certain NSAIDs, such as ibuprofen or naproxen, are the most common medications that would provide relief to the individual from the menstrual cramping and pelvic pain. These medications do not affect the endometrial implants or the endometriosis progression. They only help to relieve pain. If the pain subsides with NSAIDs, then the doctor may not go for any other procedures or medical treatments. On the other hand, if the medications fail to show any progress, then the doctor would carry out further tests and diagnoses to judge the effective treatment required.
Gonadotrophin releases hormones, or Gn-RH blocks the ovarian-stimulating hormone production, which also lowers the estrogen levels and prevents menstruation in women. The endometrial tissues also shrink. Once you stop using this medication, the periods also normalize, along with the ability to get pregnant.
At times, oral contraceptive pills are also suggested to treat endometriosis. Some women who complain of severe menstruation pain are asked to take oral contraceptive pills on a continuous basis. If taken on a continuous basis in this manner, the pills will stop menstruation. Side effects, such as nausea, vomiting, irregular bleeding, or sudden weight gain, may occur in certain women.
Danazol is a synthetic drug that creates androgen on the higher side and estrogen on the lower side. Most of the women taking this medication would have relief from pain and also find shrinkage in the endometriosis implants. However, there would be some women who would complain of side effects, such as shrinkage in breast size, edema, hair growth similar to male pattern, mood swings, skin that turns oily, and acne.
When the symptoms become severe or the body has not responded positively on the medications, then the doctor would suggest going in for surgical procedure. In case of a conservative surgery, the endometrial implant can be excised or destroyed by different sources of energy, such as electrical current, laser, etc. Although surgical treatments are effective in reducing pain, there are chances of endometriosis recurring after a certain period of time.
Once the woman reaches the menopause stage, the endometriosis symptoms usually go away, since it majorly affects women during reproductive years. Medications are always available if the symptoms persist, and these would also provide relief from pain.
