How is endometriosis diagnosed?

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 24, 2024
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Endometriosis is a condition where the uterine lining grows outside of the uterine cavity, commonly seen in the pelvic region, particularly above the ovaries. Therefore, ultrasound (B-ultrasound) examinations are primarily used for accuracy. The ultrasound may reveal a large mass on one side of the fallopian tubes or ovaries, with uneven content inside. During the ultrasound, it can also be observed that the capsule of the mass is intact. Additionally, during a gynecological examination, the doctor may also feel a mass in the adnexa.

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Written by Shen Li Wen
Obstetrics and Gynecology
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How is endometriosis diagnosed?

The gold standard for diagnosing endometriosis in women is laparoscopy. Under laparoscopy, the lesions of endometriosis can be clearly seen, the severity of the condition is understood, and it can also serve as a surgical treatment. However, generally speaking, this method of examination tends to be relatively expensive, so other methods are usually used for a comprehensive evaluation. For example, understanding the normal menstrual cycle, the duration of menstruation, and the presence or absence of dysmenorrhea. In addition, some related auxiliary examinations, such as vaginal ultrasound, can be combined to check for any abnormal cysts on the ovaries and the echo characteristics of the cyst content. Blood tests for CA125 can also aid in the diagnosis if a significant increase is observed.

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Written by Zhang Hui
Obstetrics and Gynecology
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How many days does the pain from endometriosis last?

Endometriosis refers to the condition where active endometrial cells implant outside the uterine lining. It is a relatively common gynecological disease. Pain usually begins one to two days before menstruation starts, is most severe on the first day of menstruation, and gradually lessens thereafter. The pain generally persists throughout the menstrual period. It is advised that patients with endometriosis seek timely treatment under the guidance of a clinical doctor, based on their individual conditions, to prevent the progression of the disease and serious health consequences.

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Written by Yue Hua
Obstetrics and Gynecology
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Consequences of Endometriosis

The consequences of endometriosis primarily include abnormal menstruation and infertility, with about 50% of those affected experiencing infertility. The reasons for this stem from the abnormal pelvic structures caused by endometriosis, as well as extensive adhesions of the fallopian tubes and ovaries, and abnormal motility of the fallopian tubes, all of which lead to reduced functions in transporting sperm and eggs. Furthermore, changes in the microenvironment within the pelvis also lead to infertility. Abnormal menstruation is mainly characterized by an increased amount of menstrual flow and prolonged menstrual periods, which can easily lead to anemia in patients.

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Written by Hou Jie
Obstetrics and Gynecology
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Does endometriosis require the removal of the uterus?

Endometrial displacement, depending on the specific location of the displacement, calls for different treatments. When the endometrial glands and stroma invade the myometrium, it is called adenomyosis. Treatment is based on the patient's symptoms, age, and fertility requirements. If there are fertility requirements, or the patient is near menopause, medicinal treatment can be tried to alleviate symptoms. For younger patients with adenomyosis who have reproductive needs, focal excision surgery can be considered. For patients with severe symptoms, who either have no reproductive needs or for whom medicinal treatment is ineffective, a total hysterectomy may be considered.

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Obstetrics and Gynecology
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Causes of endometriosis

The causes of endometriosis are not yet fully understood, but the theory of endometrial implantation is recognized by most experts and scholars. The main reason is that during menstruation, endometrial glandular epithelium and stromal cells can retrograde with menstrual blood, enter the pelvic cavity through the fallopian tubes, implant on the ovaries and adjacent pelvic peritoneum, and grow and spread there, forming pelvic endometriosis. Most clinical and experimental data also support this theory, indicating that approximately 70%-90% of women experience menstrual blood retrograde. Additionally, congenital vaginal atresia can also lead to endometriosis, as well as iatrogenic endometrial implantation, such as abdominal scar implantation after cesarean section or endometriosis at the perineal incision site after childbirth. These factors may also contribute to the development of endometriosis.