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Diagnosis of Endometriosis

Endometriosis is very poorly diagnosed, and it usually takes up to 11 years from when symptoms were first reported. This is a significant issue for women hoping to get pregnant as it’s a major cause of infertility and affects 10-15% of women in the general population.

Endometriosis reduces monthly conception rates by 50%, and it affects 35-50% of women who don’t conceive within two years of trying. We think it’s important that women understand the symptoms and risks of endometriosis so they can seek help as soon as possible and also adjust their habits to improve their fertility health.

At the moment, the options for diagnosing endometriosis revolve around the results of surgery and lesion biopsies, which are expensive and invasive. The challenge to find better ways to diagnose the condition is leading to new options, including taking into account symptoms. As 90-95% of women with endometriosis have symptoms (and infertility is one of them), this seems sensible.

Diagnosis is complicated by there being three distinct types of endometriosis:

  1. Superficial peritoneal lesions
  2. Cysts that create “endometriomas”, which are often in or on ovaries
  3. Deep infiltrating endometriosis (DIE)

To make things more difficult:

  1. Endometriosis grows in a variety of locations,
  2. It can look and behave differently
  3. The severity of the conditions can have little connection to pain and other symptoms
  4. Endometriosis in adolescent girls often differs from adults, which also affects diagnosis rates


Some techniques can diagnose some types of endometriosis accurately but can’t detect other types at all. Several avenues are currently being explored to find non-invasive and accurate tests that can be easily accessible, including. [ii]

  1. Surgery
  2. Imaging
  3. Blood tests
  4. Microbiome tests

Photo by Hush Naidoo Jade Photography on Unsplash

[i] By BruceBlaus. Medical gallery of Blausen Medical 2014 WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436
[ii] L. Kiesel & M. Sourouni (2019) Diagnosis of endometriosis in the 21st century, Climacteric, 22:3, 296-302, DOI: 10.1080/13697137.2019.1578743

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