Endometriosis Diagnosis and Treatment
If your doctor suspects you have endometriosis, he or she may perform one or more of the following tests:
- A pelvic exam. During this physical examination, your doctor will examine your internal reproductive organs. He or she will see if they can feel any abnormalities, such as cysts or scar tissue.
- A pelvic ultrasound. This common imaging test uses an ultrasound wand to produce pictures of your reproductive organs. It is used to look for cysts or other abnormal masses associated with endometriosis.
- Magnetic resonance imaging (MRI). This imaging test is often performed when deeply infiltrative disease is suspected. This can provide additional details of your anatomy and assist with preoperative planning.
- Laparoscopy. While other tests can help detect signs of endometriosis, the only way to absolutely confirm it is through surgical removal and examination with a microscope. This surgery is typically performed utilizing laparoscopy, which uses a small camera and 5mm instruments. The surgery is performed under general anesthesia and allows examination of pelvic and abdominal organs for endometriosis removal.
Medical and surgical options are available to help reduce symptoms and manage complications. Your doctor will help determine what is best for you depending on your symptoms and reproductive goals.
- Pain Medications: Over-the-counter pain relievers including ibuprofen can help with the discomfort.
- Hormone Therapy: Taking hormonal suppression can sometimes relieve pain and decrease the progression of endometriosis. These methods may include birth control pills, patches, vaginal rings, injections, or an intrauterine device. These methods help you regulate the monthly change in hormones that promote tissue growth that occurs with endometriosis.
- Excision of Endometriosis: This surgical procedure can typically be performed using a laparoscopic technique through small incisions. It includes full removal of all endometriosis implants. Ablation, or burning, of endometriosis can have limitations; therefore, excision is typically the preferred method of removal. Excision of implants also allows for examination under the microscope to confirm the diagnosis.
- Hysterectomy: A hysterectomy is often a last resort if your endometriosis is not improving with other treatments. If a hysterectomy is performed, all other areas of endometriosis must also be excised to optimize pain relief. This procedure involves the removal of your uterus and cervix and occasionally your ovaries.