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Endometriosis — Diagnosis And Treatment Options

by — Last updated: 2023-03-23 in Women's Health

Table of Contents

Worldwide, as many as 178 million women suffer from endometriosis. The disease causes pelvic pain and irregular bleeding, and is a common cause of infertility. Discover what the symptoms of endometriosis are, how it is diagnosed and how it can be managed.

Women who experience suspicious pelvic symptoms, bleeding, an ectopic pregnancy, repeated miscarriages or infertility may have taken that first step to see their family doctor, or an obstetrician/gynecologist. You will discuss your symptoms, medical history, and risk factors during this first appointment. Endometriosis has a strong genetic component — if your mother has or had endometriosis, you are around seven times more likely to develop the disease yourself. This explains why it is important to familiarize your doctor with your medical history.

Soon enough, your healthcare provider will come to the conclusion that endometriosis is a very real possibility.

A woman's symptoms, medical history and risk factors are often enough to presume endometriosis. An endometrial biopsy is, however, the only way to diagnose the disease with certainty. A laparoscopy is a pelvic operation that is carried out through small incisions in the abdomen. Endometrial implants in organs surrounding the uterus can actually be removed during a laparoscopic procedure, but it will initially be used to visually assess the presence of endometrial implants and to take an endometrial biopsy that can then be examined in a laboratory.

Treating Endometriosis

Endometriosis cannot be permanently cured, but it can often be managed very successfully, allowing patients to live fulfilling lives not seriously impacted by the disease. The path an individual woman with endometriosis and her doctor will choose depends on many factors including her age, the severity of her symptoms, the extent of endometrial implants and whether she would like to have children. Pain and infertility are the two biggest concerns when it comes to the management of endometriosis. 

Endometriosis treatment options include:

  • Expectant management — also known as a “wait and see” approach. This approach is suitable for those women who do not experience symptoms and do not want to get pregnant. Women who choose this option would have checkups every six to 12 months to evaluate whether the condition has changed or progressed. 

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to manage the pain.

  • Hormonal medications to prevent the endometriosis from worsening, or to manage the symptoms. For women who do not want to get pregnant, combined oral contraceptives (the birth control pill) many decrease symptoms.

  • Laparoscopic excision surgery to remove endometrial implants. While this surgery does not prevent endometrial growths from returning, it does tend to temporarily improve symptoms. The surgery is also the biggest hope for women who would like to conceive naturally. The chances of getting naturally are the biggest within 12 months of the laparoscopic excision surgery.

  • Hysterectomy for women with severe endometriosis who do not want to get pregnant.

  • IVF treatment for women with endometriosis-related blocked fallopian tubes. Research suggests that IVF success rates are slightly lower for women who have endometriosis, but also that most endometriosis patients who have IVF manage to get pregnant and stay pregnant.

The Endometriosis Foundation of America strongly believes that laparoscopic excision surgery is the gold standard for treating endometriosis. Why?

The surgery removes all endometrial growths, returns the normal function of the affected organs, and will result in the elimination or great reduction of endometriosis symptoms. Women who have been diagnosed with endometriosis and are interested in undergoing excision surgery should consult their specialist about the risks and benefits in their own personal case before going ahead with the surgery. During these consultations, it is always important to keep in mind that the surgery does not prevent endometrial implants from returning.

Endometriosis can be managed in numerous different ways, and some women choose to incorporate alternative medicine into their treatment plans as well. This overview only covers conventional treatments, but it is good to note that acupuncture and traditional Chinese approaches are often beneficial as well. Consult your doctor before you add alternative medicine to your management routine.