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Diagnosis, first stage of treatment

A detailed interview with the doctor (history-taking) forms the basis for the diagnosis. When a patient describes her symptoms and problems precisely, the doctor may already suspect endometriosis.

In the gynaecological examination, the doctor may be able to see or palpate large endometriosis sites directly (for example in the vaginal vault, on the bowel and the support ligaments of the uterus).

Ultrasound provides a means of precisely identifying any endometriosis cysts located on the ovaries. These cysts, also called “endometriomas”, contain old blood and appear on the ultrasound as a typical, regularly shaped image.

However, a normal ultrasound does not necessarily rule out the presence of endometriosis. In some cases other imaging techniques such as magnetic resonance imaging (MRI) may help to identify endometriosis sites that are developing, for instance, in the ligaments (support apparatus for the uterus) or in the uterine muscles: this is a form of endometriosis known as adenomyosis.

The most reliable method for diagnosing endometriosis, however, is direct examination of the abdominal cavity with the aid of an endoscope (examination known as a laparoscopy).

The four stages of diagnosis

  1. Detailed interview (history-taking)
  2. Gynaecological examination (palpation and careful inspection of the vagina and cervix with the aid of a magnifying instrument)
  3. Imaging techniques such as ultrasound or MRI (magnetic resonance imaging)
  4. Laparoscopy to confirm the diagnosis categorically and possibly to remove endometriosis sites at the same time

Supported by AstraZeneca