In case of suspected endometriosis, a gynecologist may recommended the performance of some tests to evaluate the uterine cavity and endometrium, such as transvaginal ultrasound, MRI, and CA 125 marker dosage in the blood. However, when the symptoms become very intense, the doctor may recommend performance of tests to evaluate other parts of the body so as to verify the severity of endimetriosis.
Endometriosis is characterized by the presence of endometrial tissue, which is the tissue that internally coats the uterus and places outside the uterus such as in the peritoneum, ovaries, bladder or intestines. Usually, the gynecologist performs these tests when there is suspicion of the disease and other symptoms are experienced such as very intense menstrual cramps, pain during intimate contact and difficulty getting pregnant.
Tests that are normally done to make the diagnosis of endometriosis include:
1. Gynecological examination
A gynecological examination can be performed to verify and diagnose endometriosis. This is done by observing the vagina and uterus with a speculum. In addition, depending on the characteristics observed, the gynecologist can also examine the uterus to look for cysts which may indicate the presence of intestinal endometriosis.
2. Pelvic or transvaginal ultrasound
Ultrasound examination is one of the first tests that is performed during the diagnosis of endometriosis and may either be pelvic or transvaginal. To do this examination, it is recommended to completely empty the bladder as this will make it possible to visualize the organs properly.
This exmaination is also very useful in the diagnosis of ovarian endometriosis, in which the endometrial tissue grows in the ovaries. It can also detect endometriosis in the bladder, vagina and resonum wall.
3. BLOOD test CA 125
CA 125 is a marker that is present in the blood and dirty dosage is usually requested to assess the risk of the person developing cancer or ovarian cyst and endometriosis because in these conditions the levels of CA 125 in the blood are high. Thus, when the result of CA 125 is greater than 35 IU/mL it is important that the doctor does other tests in order to confirm the diagnosis.
Magnetic Resonance Imaging is done when ovarian masses are suspected and that there is a need for better evaluation. It is also done to investigate the presence of deep endometriosis, which affects the intestine. This examination may show scattered fibrosis and changes in the pelvis, subcutaneous tissue, abdominal wall, and even the diaphragm surface.
This is the best test to identify endometriosis because it leaves no doubt about the disease. However, it is not the first test that is performed since it is more invasive. Besides, it still possible to complete the diagnosis through other tests without the need for a laparoscopy.
In addition to being able to detect endometriosis, laparoscopy may also be done to monitor the evolution of the disease and verify if there is a response to the treatment.
There are other complementary tests that can also be done such as uro-resonance or rectal echoendoscopy, as they help to better observe the places where endometrial tissue is growing so that treatment can be started. Treatment can be done with a continuous pill, that is taken for 6 months. During this period, the doctor may repeat laparoscopy to assess the evolution of the disease.
In the most severe cases, surgery may be required to remove tissue that is growing outside the uterus as they can cause infertility if the pelvic organs are also removed.