How Is Endometriosis Diagnosed Tests, Exams, and More Everyday Health MenuNewslettersSearch Endometriosis How Is Endometriosis Diagnosed By Beth LevineMedically Reviewed by Kacy Church, MDReviewed: February 4, 2020Medically ReviewedA biopsy, or analysis of a sample of tissue, is the only way to definitively diagnosis endometriosis. If positive, results will indicate the type, stage, and severity of disease, which can help guide treatment.Noel Hendrickson/Getty ImagesAn endometriosis diagnosis is no simple matter. According to statistics, it can take a woman anywhere from 3 to 11 years to get a proper endometriosis diagnosis. (1) RELATED: Unrecognized Endometriosis: Despite 40 Years of Severe Pain Misdiagnosed as IBS, This Woman Didn’t Give Up Find the Right Doctor for Pelvic Pain Diagnosis and Treatment Your first step is to find appropriate care. Many physicians, including gynecologists, don’t have special training in endometriosis, so it's critical that you find a specialist who is knowledgeable about and experienced in handling the disease. (2) There is no need to suffer for years with no diagnosis, a misdiagnosis, or improper care.Search online for “centers for endometriosis care.” These are centers that specialize in the disease, know what to look for, and know how to treat it.Be prepared to travel. Many insurance companies will cover out-of-network specialists as in-network if there is no specialist within 50 miles of your home. If you do have to travel, the center usually will help with arrangements and discounted hotel rooms.Check out local and national endometriosis support groups, endo bloggers, and Facebook groups. RELATED: When to See a Doctor for Heavy Bleeding Prepare for Your Appointment When you get a good referral, gather as much background information as possible to show the doctors to help them see your situation clearly. (2) Questions to Expect What are your symptoms and when did they start? Be very specific.What are your pain levels?Does the pain follow a particular pattern?Do certain activities cause a flare-up?What are you currently doing to alleviate symptoms? (Do not lie or skip over alternative therapies. The healthcare team needs a complete picture in order to help you.)Bring all your medical records. Especially important is any pelvic surgery (endometrial cells can attach to hysterectomy or cesarean scars), early onset menstruation, short menstrual cycles, never having borne a child, late onset menopause, uterine abnormalities, and family history of endometriosis. Questions to Ask the Doctor s Do the doctors specialize in endometriosis and related diseases? If not, do they work cooperatively with specialists who do?Are they willing to explain treatment options and the reasons for them?There is no cure for endometriosis. Can they express in detail what their specific goal is for you? Does that match the goal you have for yourself?If you are interested in trying complementary and alternative therapies, are they open to that?Are they willing to consider you as a partner in your care? (2) Questions to Ask Yourself After the AppointmentDo you feel comfortable talking to the doctors and staff?Will you be able to express your concerns to them? Red Flags to Watch for in Your Healthcare SearchDoctors who don’t present you with all treatment options.Doctors who refuse to discuss why they are recommending certain therapies or surgeries, and what they hope to achieve.Doctors who dismiss your concerns or symptoms.Doctors who ignore pelvic pain without considering endometriosis as a diagnosis.Doctors don’t recommend laparoscopic surgery to diagnose endometriosis if the diagnosis is unclear. RELATED: How a Delayed Endometriosis Diagnosis Helped One Woman Find Her Voice Your Doctor s Diagnostic Process for Endometriosis Diagnosis is key, because your symptoms may be related to serious conditions other than endometriosis, such as celiac disease, pelvic cancer, or pelvic inflammatory disease. (3) The only way to know for sure is to undergo laparoscopic surgery. But before recommending diagnostic surgery, your doctor will probably take a number of steps to rule out other health conditions behind your symptoms, and to see if surgery is unnecessary.Pelvic exam Your doctor will check for large cysts or lumps of scar tissue around your uterus by gently palpating the area to see if this causes pain. She will also insert a finger into your vagina and anus while continuing to palpate outside. The doctor will look inside your vagina with a speculum. Depending on what is found, a decision will be made to continue with diagnostic surgery. (4)Imaging tests Your doctor may recommend an ultrasound to check for ovarian cysts or abnormal tissue growth. For the ultrasound, a doctor or technician may insert a wand-shaped probe into your vagina or move a scanner across your abdomen. Magnetic resonance imaging (MRI) is another common imaging test that your doctor may recommend to look for endometriosis. (4)Medication Your doctor may prescribe certain hormone medicines, such as hormonal birth control pills, to help lessen painful periods. Other medication may include gonadotropin-releasing hormone (GnRH) agonists. These drugs help reduce pelvic pain by blocking the menstrual cycle and lowering the amount of estrogen in the body. (5) Laparoscopy Surgery Is the ' Gold Standard' for Diagnosis On the horizon: Scientists are researching methods that may provide noninvasive diagnoses by analyzing menstrual blood or urogenital swabs. Until then, the most common procedure for diagnosing endometriosis is called laparoscopy. In this procedure, which requires general anesthesia, your doctor will make a few small cuts in your abdomen and pelvis, then insert a small viewing device (called a laparoscope) that contains a tiny light and camera. The laparoscope allows your doctor to see the surface of your intestines and reproductive organs and to check for any patches of abnormal tissue growth that look like endometriosis. In some cases, your doctor may also perform a biopsy to confirm the diagnosis. This means taking a small sample of tissue from a suspicious area to be analyzed. A biopsy will not only help make a diagnosis, but if the diagnosis is positive, it will reveal information about type, stage, and severity, which can help guide your treatment. You may experience mild pain or cramping, but you should be back on your feet within a day. (6) RELATED: Understanding Bowel Endometriosis Why Is Delayed Diagnosis of Endometriosis So Common Why is it so difficult for people with endometriosis to get timely diagnoses? There are several problems. There's a shortage of endometriosis specialists, and general ob-gyns lack knowledge about and training in the disease. In fact, as Tamer Seckin, MD, an endometriosis surgeon and the founder of the Endometriosis Foundation of America and the Seckin Endometriosis Center points out, “There is not yet an official fellowship for endometriosis surgery.” Another problem is there is often a lack of communication between gastroenterologists and gynecologists. A woman might go to the former for pelvic issues, but the gastroenterologist never recommends that she see her gynecologist about it. The patient never considers that a stomach issue could be gynecologically related. Or, in the most dreaded scenario, the patient is told the pain is all in her head or that it's normal menstrual pain. Barriers to Endometriosis Care The Society for Women’s Health Research has been questioning this lack of attention to this disease, and in August 2019 put out a call to action for research to address the “gaps and unmet needs in endometriosis.” NEWSLETTERS Sign up for our Women' s Health Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. Editorial Sources and Fact-Checking Husby GK, et al. Diagnostic Delay in Women With Pain and Endometriosis. Acta Obstetricia Gynecologica Scandinavica. July 2003.Seeking a Doctor: Finding the Right Endometriosis Specialist. Endometriosis Foundation of America.Endometriosis. Penn State Hershey Medical Center.Malcolm E. Endometriosis Diagnosis: What You Need to Know. Endometriosis News.Wood R. GnRH. Endometriosis.org.Johnson E. Laparoscopy: Before and After Tips. Endometriosis.org.Show Less The Latest in Endometriosis FDA Approves Myfembree for Endometriosis Pain in Premenopausal WomenDoctors were already prescribing the drug to manage uterine fibroid–related heavy menstrual bleeding, and now the medicine will be immediately available...By Lisa RapaportAugust 9, 2022 Endometriosis May Raise Risk of Stroke Study FindsWhile the overall risk is low, the link between endometriosis and cardiovascular disease is worth paying attention to.By Kaitlin SullivanJuly 25, 2022 New Study Finds Link Between Endometriosis and Early MenopauseWomen with endometriosis may have fewer reproductive years than those without the condition, especially if they’ve never had children or taken the pill...By Becky UphamJanuary 28, 2022 Does Low Testosterone Cause Endometriosis A new theory may change diagnosis and treatment of the disease.By Beth LevineMay 28, 2021 Everyday Health s Endometriosis Twitter Chat Here s What You MissedAdvocates and experts took to Twitter to discuss challenges, tips, awareness, and more in honor of Endometriosis Awareness Month.By Brianna MajsiakApril 13, 2021 Does Endometriosis Up Your Risk for Developing Rheumatoid Arthritis There’s a connection between endo and RA, according to a large study.By Beth LevineJanuary 19, 2021 Managing Endometriosis During the Coronavirus Crisis FAQsAn expert answers frequently asked questions from women with endo By Beth LevineApril 2, 2020 Model and Advocate Alaia Baldwin Aronow Opens Up About Her EndometriosisThrough advocacy and sharing vulnerable images of her ‘endo belly,’ Aronow wants other women to feel less alone.By Brianna MajsiakMarch 31, 2020 Together Against Endo Kari and Ryan Anderson Help Raise Endometriosis AwarenessFacing the disease as a couple helped Kari and Ryan Anderson persevere and start a family.By Michael DolanMarch 26, 2020 Experiences With EndometriosisAn open, honest, and raw conversation about what life with endo is really likeBy Kerry WeissMarch 19, 2020 MORE IN Diagnosing Lymphoma What Can I Expect Autism Diagnosis Screening and Testing How Dementia Is Diagnosed