The symptoms can be quite colorful and non-specific – one of the reasons that the diagnosis is often made late. The extent of the symptoms does not necessarily depend on the extent of the endometriosis – for example, small foci can cause severe symptoms and large foci can only be discovered by chance. Commonly described signs of the disease are:
- Abdominal and back pain, often radiating to the legs, pain associated with sexual intercourse, pain during examination by the gynecologist.
- Heavy or irregular menstrual bleeding.
- Bladder and bowel cramps, pain when urinating or having a bowel movement
- Cyclic bleeding from the bladder or bowel, cyclic cough (if metastasized to the lungs).
- Involuntary childlessness
Complaints are cycle dependent
Typical of endometriosis is that the complaints become stronger depending on the cycle and then decrease or disappear. The peak is one to three days before the onset of bleeding, with the decrease in menstruation, the symptoms also decrease again.
Depending on the location of the endometriosis lesions, however, the symptoms can also be completely uncharacteristic or occur continuously, for example, if adhesions have already occurred.
How is the diagnosis made?
First, the doctor will take the medical history and ask exactly what the symptoms are. During the gynecological palpation, he may already be able to see or feel foci in the vagina; this is followed by an ultrasound examination.
Depending on the question, further examinations, such as an MRI, may also be useful. However, definitive diagnosis always requires examination of a tissue sample, which can usually only be obtained during laparoscopy.
