Endometriosis- diagnosis and treatment

With the start of the new year we also begin a new collection of articles. This month, we will focus on endometriosis. Endometriosis, such an enigmatic disease that affects up to 15% of women of reproductive age yet there is no cure for it currently. Only a treatment to alleviate the symptoms exists. Endometriosis has significant effects on the social, occupational, psychological, and physiological life of women.

Last week we looked into what exactly endometriosis is and what the symptoms are.

But how can it be diagnosed and the symptoms treated? Let’s find out!

How is endometriosis diagnosed?

Unfortunately, as endometriosis is usually diagnosed later, the difference of time between the first symptoms and the actual diagnosis can range from 4 to 11 years. Factors that lead to such a late diagnosis can be the “normalization” of the symptoms or misdiagnosing. Interestingly enough, the delay in diagnosis is a global phenomenon, without any connection to the medical standard of one’s country. This just proves how endometriosis still is not fully elucidated and why it affects so many women. As an outcome of this delay in diagnosing, endometriosis can evolve and spread to other organs and can compromise fertility.

These are some of the current diagnosis methods

1. Ultrasonography

  • It is considered to be the first line tool for detection

  • It improves accuracy of a diagnosis when combined with symptoms overview, patient history and physical examination.

  • It can detect ovarian endometriosis and deep endometriosis with high accuracy

2. Laparoscopy

  • It is the gold standard for diagnosis as it provides a direct visualization of lesions (wounds)

  • Laparoscopy is a type of surgery performed in the abdomen or pelvis. It uses small cuts through which a small camera can be inserted for diagnosis or treatment purposes.

3. Clinical diagnosis

  • diagnosing without any surgical method sometimes even decreases the time between the first consultation and the diagnosis.

  • This method requires specific clinical methods that can accurately diagnose endometriosis

  • Such methods include: family history, the existence of previous pelvic surgery, a history of benign ovarian cysts and/or ovarian pain, menstrual cycle characteristics (heavy menstrual bleeding, excessive/irregular bleeding, irregular menstrual periods, passing clots, premenstrual clotting) and physical examination (pelvic examination)

In case of an endometriosis spreading deep into other organs, other investigations, such as colonoscopy, rectal ultrasonography and MRI can be performed. Studies suggest that the likelihood of endometriosis increases with the number of symptoms presented. Several studies used this approach to develop models that predict endometriosis.