I have chronic pelvic pain and think I might have endometriosis. What tests should I expect?

Endometriosis is an often painful disorder in which tissue similar to the tissue that normally lines the inside of your uterus (the endometrium) grows outside your uterus. But many conditions can cause pelvic pain. So, you might need a variety of tests to help your doctor determine what's behind your pain.

Your doctor will likely start by asking you about:

  • The location of your pain, when it occurs and how it feels
  • Your menstrual cycles and bleeding history
  • Your personal health history
  • Your family health history

Being ready to discuss these questions at your appointment can be helpful. For example, if you have a family history of endometriosis, which increases your risk of the condition, telling your doctor that information will help with the evaluation.

Tests or exams your doctor might then suggest include:

  • Pelvic exam. During a pelvic exam, your doctor feels for abnormalities around your uterus and ovaries (pelvic area), including checking for tenderness. This exam can reveal signs of infection, abnormal thickening or lumps, or tense pelvic floor muscles. Often it's not possible to feel small areas of endometriosis, unless they've caused a lump to form.
  • Lab tests. Your doctor may order lab tests to check for infections, such as chlamydia or gonorrhea. Your doctor may also order bloodwork to check your blood cell counts and a urinalysis to check for a urinary tract infection.
  • Ultrasound. This test uses high-frequency sound waves to produce images of structures in your pelvic area. To capture the images, a device called a transducer is either pressed against your belly (abdomen) or inserted into your vagina. Both types of ultrasound may be done to get the best view of your uterus and ovaries. A standard ultrasound imaging test won't definitively tell your doctor whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas).
  • Magnetic resonance imaging (MRI). An MRI is an exam that uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body. For some, an MRI helps with surgical planning, giving your surgeon detailed information about the location and size of endometrial implants.
  • Laparoscopy. During this surgical procedure, your doctor makes a small incision in your abdomen and inserts a thin tube attached to a small camera (laparoscope). The laparoscope allows your doctor to look for signs of endometrial tissue outside the uterus.

    A laparoscopy can provide information about the location, extent and size of the endometrial implants. Your surgeon may take a tissue sample (biopsy) for further testing. Often, with proper surgical planning, your surgeon can fully treat endometriosis during the laparoscopy so that you need only one surgery.

Finding the cause of pelvic pain can be a challenging process. But with patience and open communication with your doctor, you can work together to find a treatment plan that minimizes your pain.

Jan. 30, 2020 See more Expert Answers