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Endometriosis - How do doctors diagnose endometriosis?

BMJ Group Medical Reference

Doctors often don't spot endometriosis straight away. Many women see several doctors, over many months or years, before they find out they have endometriosis and get treatment.

There are several reasons why endometriosis is hard to spot.[26][37]

  • The symptoms are very different in different women.

  • Some women have no symptoms at all.

  • Some other illnesses have the same symptoms as endometriosis.[25] Many girls and women go to the doctor because they have painful periods. Only about half of them turn out to have endometriosis.[21] To learn more, see Other illnesses with symptoms like endometriosis.

  • There's no simple test for endometriosis. You need to have a type of surgery for doctors to know for certain whether you have endometriosis. It's called a laparoscopy. A surgeon looks inside your body using a small camera. See below for more information.

  • If you have painful periods but no other symptoms, your doctor may recommend that you try treatments such as painkillers or the contraceptive pill, before choosing to have a laparoscopy. If the treatment works, you may not need to have a laparoscopy. See Simple treatments for painful periods.

Questions your doctor may ask

Your doctor (either your GP, a specialist, or both) may ask you about your symptoms and how they affect you. You may be asked questions about your sex life and your periods. These questions might include:

  • When did your periods start?

  • Do you get painful periods? Where is the pain? When does it happen exactly?

  • How many different people have you had sex with in the last few months?

  • Does it hurt when you have sex? If so, where does it hurt?

  • Have you ever had a sexually transmitted disease?

  • Have you had difficulty getting pregnant?

Physical examination

Your doctor (your GP, a specialist, or both) may examine the area between your hips (your pelvis), so you may need to get undressed.

You may also have an internal examination. Your doctor will put a gloved finger in your vagina, and a hand on your tummy. This lets your doctor feel your internal organs from the outside. It's best to do this during the first two days of your period. The doctor is feeling for:[2]

  • Bulges or tight areas (to see if parts of your body are stuck together)

  • The position of your womb (it should lean forward not backward)

  • Tender areas (this might mean you have endometriosis in these places)

  • Signs of other illnesses that might be causing your symptoms (see Other illnesses with symptoms like endometriosis).

However, even if your doctor doesn't find anything wrong, you could still have endometriosis. You need a laparoscopy to be certain.

Sometimes an internal examination may be a bit uncomfortable. If you're nervous, take someone with you.

You don't have to have an internal examination. Your doctor will skip it if you're too young, too nervous, or don't want it.

Last Updated: November 06, 2013
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
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