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 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. Ultrasound is especially useful for detecting masses or cysts in the pelvic area.
- X-ray, CT or MRI. X-rays, computerized tomography (CT) scans or magnetic resonance imaging (MRI) of your abdomen can also help detect abnormal structures or lumps.
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 view your pelvic organs and check for abnormal tissues or signs of infection. This procedure is especially useful in detecting endometriosis, scar tissue and possible signs of inflammation.
A laparoscopy is the only way for your doctor to know for sure whether you have endometriosis. However, because all surgery comes with some risk, your doctor might suggest medications first. Your doctor might recommend a laparoscopy if your symptoms don't improve with treatment or if you're having difficulty getting pregnant.
Finding the cause of pelvic pain can be a long 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, 2018
- Barbieri RL. Causes of chronic pelvic pain in women. https://www.uptodate.com/contents/search. Accessed Dec. 27, 2017.
- Barbieri RL. Treatment of chronic pelvic pain in women. https://www.uptodate.com/contents/search. Accessed Dec. 27, 2017.
- Frequently asked questions. Gynecologic problems FAQ099. Chronic pelvic pain. American College of Obstetricians and Gynecologists. https://www.acog.org/Patients/FAQs/Chronic-Pelvic-Pain. Accessed Dec. 27, 2017.
- Tu FF, et al. Evaluation of chronic pelvic pain in women. https://www.uptodate.com/contents/search. Accessed Dec. 27, 2017.
- Speer LM, et al. Chronic pelvic pain in women. American Family Physician. 2016;93:380.
- Schenken RS. Endometriosis: Pathogenesis, clinical features, and diagnosis. https://www.uptodate.com/contents/search. Accessed Dec. 26, 2017.
- AskMayoExpert. Endometriosis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
- Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility: A committee opinion. Fertility and Sterility. 2012;98:591.
- Endometriosis. The National Women's Health Information Center. https://www.womenshealth.gov/a-z-topics/endometriosis. Accessed Dec. 26, 2017.