It can take time to get a diagnosis of endometriosis. The average time to get a diagnosis is seven years. This is because symptoms vary between women, and symptoms can change over time. Also, period pain is often accepted as normal.
Some women have asymptomatic endometriosis, which means they don’t experience infertility or common symptoms such as pelvic pain. In these cases, the condition may be found during an unrelated operation.
A thorough review of your symptoms, medical history and test results will improve your chances of an early diagnosis.
When endometriosis symptoms are acknowledged and treated, most women with the condition do well.
Learn more about how endometriosis is diagnosed and when to see your doctor.
Ultrasound
Laparoscopy
Magnetic resonance imaging (MRI)
Stages of endometriosis
Endometriosis in teenage years
When to see your doctor
Related resources
The first step to diagnosing PCOS is usually an ultrasound. Ultrasound uses sound waves to produce images of your body. Doctors with expert training can use ultrasound to make a ‘working diagnosis’ of endometriosis. Depending on the findings and your symptoms, you may or may not need surgery. Medical treatment can be offered based on ultrasound findings alone and this may be all you need to manage the condition. If the ultrasound is normal, your doctor may still suggest medical treatment to help relieve symptoms.
Laparoscopy is keyhole surgery (via the abdomen) performed under general anaesthetic. A laparoscopy can confirm the presence of endometrial tissue, which can be treated during the operation. This operation is usually performed when other medical management hasn’t worked, when a woman has difficulty falling pregnant or when an ultrasound suggests there is deep endometriosis and scar tissue. It’s important to minimise this type of surgery, so look for a surgeon who has lots of experience managing endometriosis.
MRI is a technology used to take cross-sectional pictures of your body. MRI may help diagnose endometriosis if it’s reported by a radiologist with experience in diagnosing the condition. Using this technology for diagnosis is still in the early stages. It may be a good option for people who can’t access specialist ultrasound scans or want to avoid surgery.
The American Society for Reproductive Medicine has created a staging system for endometriosis. Endometriosis may be classified as minimal, mild, moderate or severe (or stages one to four). The stages are based on the location, extent and depth of endometrial tissue seen during surgery.
Some research suggests that most women have superficial, or milder, forms of endometriosis, but more research is required in this area.
There are small endometrial patches or plaques, inflammation and mild adhesions (bands of scar tissue that form between two surfaces inside the body).
As above, but there are many patches and there may be some scarring. There may also be adhesions between the uterus and the rectum.
As above, but there are also adhesions on the ovaries.
As above, but there are also many implanted endometrial patches, patches that may form scarred nodules, adhesions to other organs such as the bladder and bowel, and changes to the shape of pelvic organs.
The above classifications are useful, but they don’t always reflect the severity of symptoms. For example, a woman with stage one endometriosis may have more pain than a woman with stage four endometriosis.
If there are fertility problems, a different system called the Endometriosis Fertility Index can be used to help predict pregnancy outcomes following surgery.
A diagnosis of endometriosis in teenagers can take time, but increased awareness of symptoms is helping doctors identify the condition earlier.
Symptoms such as pain before and during a period may not be endometriosis. Also, symptoms such as pain between periods or pain related to the bowel or bladder are common in teenagers without endometriosis.
Doctors may explore different treatment options, such as medicines, before recommending surgery. Medicines commonly used to reduce pain include anti-inflammatory drugs such as ibuprofen, mefenamic acid and naproxen.
Your doctor may also recommend hormonal treatments such as the combined oral contraceptive pill (COCP) and progestogens to reduce period pain.
Medical management of painful periods improves symptoms for many young women. But if pain persists and you’ve seen a doctor three or more times over a six-month period, your doctor is likely to recommend a laparoscopy. The surgery will confirm the diagnosis and treat the endometriosis.
Your doctor can refer you to a gynaecologist with specialist skills in treating endometriosis in teenage years.
It’s not OK or normal to have severe period pain. If you think you have endometriosis, see your doctor as soon as possible, as early diagnosis and treatment can reduce the severity of the condition.
It’s a good idea to keep a diary of your symptoms. This will help your doctor or gynaecologist find out what is wrong. Your doctor may ask questions about:
Download our fact sheets or visit resources for more information.
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at January 2023.
This content has been reviewed by a group of medical subject matter experts, in accordance with Jean Hailes policy.
© Jean Hailes Foundation. All rights reserved.
