Endometriosis diagnosis difficult despite symptoms


Endometriosis greatly impacts the quality of life for millions of girls and women in the United States and yet it can often take up to 10 years before many of them receive an accurate diagnosis of the disease.

According to the Endometriosis Foundation of America (EFA), one in ten girls and women in the United States are affected by endometriosis, which occurs when tissue similar to that in the lining of a uterus (also known as the endometrium) is found outside the uterus on or near other internal organs. The disease can be extremely painful for both girls and women and produce a myriad of symptoms.

The cause of endometriosis is unknown and many aspects of it are misunderstood. That coupled with a general lack of understanding among the public often leads to a prolonged diagnosis of the disease in women who are experiencing symptoms, the EFA says.

A woman’s menstrual cycle involves the growth of endometrium inside a female’s uterus once a month and is shed through the bleeding that exits through the vagina. The misplaced tissue that grows outside the uterus is also shed through bleeding, but does not have a place to exit the body. This can cause internal bleeding, infertility, scar tissue and inflammation.

The misplaced tissue can attach to any of the female reproductive organs such as the uterus, fallopian tubes and ovaries. However, it can also be found in any of the spaces between the bladder, uterus or vagina and rectum. It is less commonly found in areas such as the bladder, bowel, intestines, appendix or rectum. Symptoms may depend upon where the tissue grows and how large it becomes, the EFA says.

Endometriosis’ most common symptom is pelvic pain that coincides with menstruation. Other symptoms may include strong, painful menstrual cramps that don’t go away with the help of medication, but affect a female’s daily activities; periods that last longer than seven days; heavy periods that require a female to change her pad or tampon every two hours; bowel and urinary disorders; nausea or vomiting; pain during intercourse and infertility.

Endometriosis can only be verified by a diagnostic laparoscopy that provides a biopsied specimen to be tested. Unfortunately, the tissue is not visible on imaging tests such as MRIs, CT scans and even ultrasounds. A pelvic exam can indicate the possibility of endometriosis but it cannot confirm it.

There are many myths surrounding endometriosis. One is that endometriosis is a disease that only affects women beginning in their 20s. This is not true. Females can develop endometriosis symptoms as soon as they experience their first menstrual cycle as a girl. There is also no cure for endometriosis despite the misconception that menopause and pregnancy can put an end to it.

Females who think they may have one or more symptoms of endometriosis should talk to their physician about it. A good place to start is with a trusted doctor such as your gynecologist who knows your medical history. Girls and women can play an active role in a possible diagnosis by preparing as much as possible for the first appointment. A good starting point is by using some of the resources provided by the EFA. These include a “personal pain profile” sheet, which will help give your physician an idea of the location and severity of your pain.


Ashok Buddhadev, MD, is an OB/Gyn physician with Premier Health Specialists who practices at Upper Valley Women’s Center in Troy.

Ashok Buddhadev, MD, is an OB/Gyn physician with Premier Health Specialists who practices at Upper Valley Women’s Center in Troy.

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