Endometriosis: the importance of early diagnosis

Endometriosis is a common yet often misunderstood condition that affects millions of women worldwide, particularly those in their reproductive years. It occurs when tissue similar to the lining inside the uterus (the endometrium) starts to grow outside the uterus, commonly on the ovaries, fallopian tubes, or pelvic lining. This misplaced tissue still acts like normal endometrial tissue: it thickens, breaks down, and bleeds with each menstrual cycle.

However, because this tissue is trapped in places it shouldn’t be, it can cause inflammation, scarring, and intense pain. We speak to a leading consultant radiologist, who address some common questions around endometriosis to help guide those who may be affected.

Why is early diagnosis so important?

Early diagnosis is crucial for managing endometriosis effectively. Unfortunately, many women experience years of symptoms before receiving an accurate diagnosis, often because the condition is mistaken for other ailments, like irritable bowel syndrome (IBS) or pelvic inflammatory disease (PID). A delay in diagnosis can mean years of unmanaged pain and a risk of progression to more severe forms of endometriosis, which may impact fertility and lead to other complications.

Diagnosis typically involves a combination of medical history, pelvic examination, imaging tests like ultrasound, and sometimes a laparoscopy—a surgical procedure where a small camera is inserted into the pelvis to detect endometrial tissue outside the uterus. Seeking expert guidance early on can help ensure timely diagnosis, which is vital for planning a treatment that addresses the full range of symptoms and prevents the condition from worsening.

What are the symptoms of endometriosis?

Endometriosis manifests in various ways, and symptoms can differ greatly from one individual to another. The most common symptoms include painful periods (dysmenorrhea), pain during intercourse, pelvic pain between menstrual cycles, heavy bleeding, and digestive or urinary issues. Some women may also experience fatigue, bloating, and even back pain.

Importantly, the severity of pain does not always correspond with the extent of the condition. Some women with severe endometriosis may experience minimal symptoms, while those with milder forms can have intense pain. Therefore, recognising the pattern and intensity of symptoms is essential to building an effective treatment plan.

How is endometriosis treated?

There is no definitive cure for endometriosis, but several treatment options can help manage symptoms and improve quality of life. Treatment plans are often personalised based on symptom severity, age, and whether the individual wishes to have children. Pain relief is often the first step, and nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly recommended. Hormone therapy, such as oral contraceptives, progestins, or gonadotropin-releasing hormone (GnRH) agonists, can help reduce or eliminate menstruation and, therefore, alleviate symptoms.

In cases where medications don’t provide enough relief, surgical options may be considered. Laparoscopic surgery allows surgeons to locate and remove or destroy endometrial tissue outside the uterus. This can be particularly beneficial for those with severe pain or for those trying to improve fertility.

Can lifestyle changes help?

Yes, lifestyle changes can play a supportive role in managing endometriosis. While lifestyle changes alone won’t treat the underlying cause, regular exercise, a balanced diet, and stress management may help reduce pain and improve overall well-being. Some patients also find complementary therapies, such as acupuncture or physical therapy, beneficial, though these are best used alongside, not as a replacement for, medical treatment.

Living with endometriosis can be challenging, but early diagnosis and an integrated treatment approach can make a significant difference. Speaking to a specialist and understanding your options is a vital first step toward relief and improved quality of life.