Dr. Kate Dudek • November 21, 2024 • 5 min read
Endometriosis is not straight-forward to diagnose. The European Society of Human Reproduction and Embryology (ESHRE) guidelines state that definitive diagnosis of most forms of endometriosis requires visual inspection of the pelvis using laparoscopy.
Work to identify a reliable biomarker of the condition that could be measured in the blood is at a very preliminary stage. Encouragingly, specific genetic alterations have recently been identified in the blood of women with endometriosis, so there is optimism that a panel of genetic markers could, one day, be identified.
Following an initial consultation, during which symptoms can be discussed and explored in detail, doctors will typically adopt a step-by-step approach when it comes to diagnosing endometriosis.
The initial consultation you have with your gynaecologist is key. It is important to have a relationship based on trust, and you need to feel that your doctor is approachable and understanding from the first meeting onwards.
Dr. Salma Kayani, an endometriosis specialist based out of Taiba Hospital in Kuwait, highlights the value of finding a doctor who has the clinical expertise to use empathy, time and experience to reach an accurate diagnosis:
“‘the bottom line is that a trained and experienced clinician can talk to the patient, do a bimanual examination, and get to an accurate diagnosis”.
It is possible that for some forms of endometriosis the use of transvaginal ultrasounds might replace the more invasive surgical techniques currently in use. A skilled radiographer should be able to use ultrasound to identify most cases of deep endometriosis affecting the pelvic cavity. They will systematically examine the following regions to look for endometrial deposits:
Endometriosis located elsewhere in the body will not be detectable using this technique. Stage I endometriosis of the pelvis, also termed minimal, or superficial disease, is also unlikely to be detectable using ultrasound investigation. Stages II to IV (mild, moderate and severe) are more likely to be detected using ultrasound.
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