How to detect endometriosis?

Unfortunately, detecting endometriosis is difficult, and the diagnostic process takes an average of 7-10 years. However, many changes have occurred in recent years, and increased awareness among women and doctors means symptoms The disease is no longer being underestimated. In this article, we discuss diagnostic methods used in women with suspected endometriosis. However, remember that the diagnosis should be supervised by an experienced physician who will guide you through the entire process step by step. 

Endometriosis diagnostic process

Diagnosing endometriosis involves several steps. Importantly, not every patient requires all methods. Endometriosis It is a difficult and insidious disease, so sometimes it can be diagnosed in one visit, but sometimes it requires several months and many tests. I would like you to remember that the sooner the disease is diagnosed, the sooner you can take action. leczenie, slow the progression of endometriosis, reduce its complications, and feel better. Don't ignore the symptoms and seek help from specialists. 

Medical interview

The first step in diagnosing endometriosis is a medical history. Your gynecologist will ask you about your symptoms, their severity, duration, and the situations in which they occur. The most common symptom associated with endometriosis is pain. However, this isn't the only ailment that can accompany the disease. During your appointment, you can expect questions about:

• Year of first menstruation,
• Regularity and abundance of menstruation,
• Cycle duration,
• Feeling pain during menstruation and other phases of the cycle,
• Feeling pain or discomfort during intercourse,
• Problems with constipation or pain during defecation,
• Pain when urinating,
• Pain in the area of ​​the sacral and lumbar spine,
• Gastrointestinal symptoms,
• Family history of endometriosis,
• Difficulty getting pregnant. 

Before your first consultation, think carefully and write down all the symptoms that worry you and anything you'd like to ask the doctor – this way, you won't miss anything and you'll feel more confident. You can use our self-observation cardsHere you'll find a simple "Is it Endo?" questionnaire, a symptom observation chart, and a "pain map" to help you better describe and localize your symptoms. And if you're looking for a good specialist, check out our list of recommended doctors. 

Physical examination

The next diagnostic step is a gynecological examination, which includes:

• Palpation of the abdominal wall,
• Endoscopy of the vaginal vault,
• Two-handed gynecological examination. 

All survey They are performed only with your consent and with your comfort in mind. This allows for a preliminary assessment of the position, size, and mobility of the uterus, as well as the condition of the uterosacral ligaments and the rectovaginal septum. This is important because endometriosis lesions are often located in these structures. The examination should be performed by a physician experienced in diagnosing this disease. Unfortunately, small changes can easily be missed during a routine gynecological examination performed by a physician who has not received appropriate training. An examination to diagnose or rule out endometriosis usually takes longer, is more precise, and focuses on slightly different structures. However, even if the examination reveals no abnormalities and your symptoms still suggest endometriosis, imaging tests are recommended.

Imaging studies

Transvaginal ultrasound is used in the diagnosis of endometriosis and magnetic resonance imagingThese tests should also be performed and evaluated by a doctor specializing in endometriosis, as they require more thorough testing than standard, routine tests.

• Standard transvaginal ultrasound can visualize endometrial cysts but may be insufficient to detect small foci of endometriosis. Therefore, to improve diagnostic yield, if endometriosis is suspected, intravaginal ultrasound is used. According to the recommendations of IDEA (International Deep Endometriosis Analysis) and the Polish Society of Gynecologists and Obstetricians, ultrasound should be performed using a specific endometriosis algorithm, which allows for the assessment of adhesions in the pelvis, bladder, intestines, and ureters.
• As a supplement, transrectal ultrasound may be performed, especially when there are functional intestinal disorders or incidents of bleeding from the lower gastrointestinal tract. 
• Magnetic resonance imaging (MRI) is very useful in diagnosing endometriosis, especially when deep lesions are suspected outside the pelvis. Unfortunately, it is also characterized by limited availability and high costs. However, it is crucial before a planned surgery to accurately map all endometrial lesions. You can read more about this in our article. "What does magnetic resonance imaging involve in the diagnosis of endometriosis?".

Laparoscopy and other surgical procedures

Laparoscopy is not a routine test in the diagnosis of endometriosis mainly due to its invasiveness. It is a treatment method used when other methods (pharmacological therapy, diet, physiotherapy, supplementation, cooperation with a psychologist) do not produce the intended results. However, endometriosis can sometimes be detected accidentally during laparoscopy or another surgical procedure performed for other reasons, such as acute abdominal conditions. For example, intestinal stenosis or obstruction requiring surgery may be caused by deeply infiltrating endometriosis that was previously undiagnosed. The diagnosis is made only during the procedure, after opening the abdominal wall reveals adhesions and endometrial foci. 

Blood tests

A major problem in diagnosing endometriosis is the lack of specific markers that could be detected, for example, in blood, urine, or saliva. This would significantly facilitate diagnosis for both physicians and patients, who must undergo numerous unpleasant tests to obtain help. Unfortunately, despite numerous clinical studies, no specific markers have yet been identified that would clearly determine the diagnosis or rule out endometriosis. 

You may have heard that if you suspect the condition, it's worth checking your blood CA-125 level. However, remember that low levels don't rule out endometriosis. High levels can indicate this condition, but they can also indicate many other issues. Therefore, this parameter should only be assessed as part of a comprehensive diagnostic process. Research is currently underway into the possibility of using brain-derived neutrophil factor (BDNF) in blood plasma and biopsy. endometrium and evaluation of markers such as interleukin 8 and VEGF for diagnostic purposes. Initial results are promising, but require further evaluation and are not currently used in routine clinical practice.

Summary

Diagnosing endometriosis isn't easy. However, it's worth going through this process to be confident about your health and develop an effective action plan. Remember that early detection of endometriosis increases the chances of slowing its progression, reducing symptoms, improving your daily well-being, and achieving pregnancy if you're planning one. Don't ignore symptoms and don't delay diagnosis. Don't give up, even if your doctor tells you it's just your appearance. Seek out specialists who have the necessary expertise and knowledge about endometriosis and will make you feel cared for. You deserve to feel good and safe in your own body.  

Źródła:

1. Kędzia M. Recommendations of the Polish Society of Gynecologists and Obstetricians regarding the management of women with endometriosis, https://www.ptgin.pl/sites/scm/files/2023-10/Rekomendacje%20ENDOMETRIOZA%2023.10.2023.png__1.pdf [accessed: 17/09/2025]
2. Position of the Expert Team of the Polish Gynecological Society on the diagnosis and treatment of endometriosis, Ginekologia Polska, 2012
3. Kwiatkowski P. Endometriosis – pathogenesis, diagnosis and treatment, https://apcz.umk.pl/JEHS/article/view/42238 [accessed: 17/09/2025]
4. Szubert M. Is it possible to diagnose endometriosis from the endometrium level? http://ginekologia.pl/assets/pdf/artykuly/030-038_cgo_1_2016_szubert_endometrioza.pdf [accessed: 17/09/2025]
5. Recommendations of the Polish Society of Gynecologists and Obstetricians regarding the treatment of women with endometriosis, https://pokonacendometrioze.pl/wp-content/uploads/2024/08/101846-439375-1-SM.pdf [accessed: 18/10/2025]