Ultrasound examinations can detect unusual tissue growth that occurs with endometriosis. The scan will focus on the area in and around the pelvis. It involves either pressing a transducer on the abdomen or inserting it into the vagina.
Endometriosis is an inflammatory condition that occurs when tissue that resembles the uterine lining develops outside of the uterus. Symptoms include pelvic pain, painful periods, and painful intercourse. Current estimates suggest that it could affect more than
This article looks at ultrasound reliability, what happens during a scan, and whether there are more accurate ways of diagnosing endometriosis.
A doctor may offer an ultrasound to a person who presents with symptoms of endometriosis.
An ultrasound uses high-frequency sound waves that bounce off organs and tissues in the pelvis to create a picture of the inside of the body.
A doctor may use a transducer pressed against the abdomen (transabdominal ultrasound) or inserted into the vagina (transvaginal ultrasound). Both work in the same way to capture an image.
A 2016 Cochrane review looked into the accuracy of ultrasound scans in diagnosing endometriosis. The review concluded that doctors may be able to identify certain severe cases of endometriosis via ultrasound, which could eliminate the need for further exploratory tests. However, endometriosis may still be present even if an ultrasound scan does not detect any. In this case, a person may require further tests.
In 2016, a consensus group called International Deep Endometriosis Analysis published a
- examining the uterus, ovaries, and fallopian tubes for growths by transvaginal scan
- looking for “soft markers,” such as ovarian mobility and site-specific tenderness
- applying gentle pressure to specific areas within the pelvis to check movement and mobility
- looking for tissue at the front and back of the pelvis, including the bladder
Authors argue that this rigorous approach would help standardize a diagnostic system and ultimately improve treatment for people with endometriosis.
During an ultrasound scan, an individual lies on their back. The doctor may request that they have an empty or full bladder, depending on the part of the pelvis they intend to check or the method of the ultrasound scan.
Transabdominal ultrasound
This noninvasive method involves pressing on the abdomen using a device called a transducer. The doctor or sonographer applies a cool jelly to the stomach before sliding the transducer over the skin. It may feel cold, and people may feel some pressure, but it should not hurt.
Transvaginal ultrasound
During menstruation, people must remove tampons before a transvaginal scan.
The doctor or sonographer inserts a small, finger-width ultrasound probe (transducer) into the vagina. They move the transducer slightly to capture images of the pelvis and look for evidence of endometriosis.
Transvaginal scans should not hurt, but they may feel slightly uncomfortable.
During an ultrasound, a doctor looks for signs that indicate the severity of endometriosis. The American Society of Reproductive Medicine has set out four endometriosis stages:
- Stage 1: Minimal: There are a few isolated and superficial implants of endometrial-like tissue.
- Stage 2: Mild: There are several implants of endometrial-like tissue that are slightly more deeply embedded.
- Stage 3: Moderate: There are many deep implants, one or both ovaries have small cysts on them, and there are fibrous bands between tissues and organs called filmy adhesions.
- Stage 4: Severe: There will be many deep implants, one or both ovaries will have large cysts, and many dense adhesions are present.
Yes, someone with endometriosis can have a normal ultrasound. Ultrasound is a valuable tool in diagnosing endometriosis, but it is not entirely accurate.
A 2021 Cochrane review into ultrasound as a diagnostic tool found that endometriosis may still be present even if a doctor finds no evidence during an ultrasound scan.
Apart from ultrasound, there are other ways to detect endometriosis, with varying levels of accuracy and reliability.
MRI scan
An MRI scan creates an image of the inside of the body. A doctor may use this in place of ultrasound to look for endometrial-like tissue.
Biomarkers
Specific biomarkers, such as elevated protein levels, may signify endometriosis. However, tests to measure these biomarkers are not
Keyhole surgery and biopsy
Laparoscopy or keyhole surgery is a
Endometriosis occurs when tissue that resembles the uterine lining, which prepares for a fertilized egg every month, grows outside the uterus. Tissue may develop on the outer surface of the uterus, behind the uterus, or elsewhere in the reproductive system, such as in or on the:
- ovaries
- fallopian tubes
- ligaments that support the uterus
Less commonly, tissue may develop in other parts of the pelvic area, such as the vagina, cervix, vulva, or bowels. Rarely, endometrial-like tissue may grow in other body parts, such as the brain, lungs, eyes, or skin.
Endometriosis is a common health problem for women. The Office on Women’s Health says around
- Pain: An individual may have painful period cramps, chronic back pain, painful bowel movements, and pain during sexual intercourse. They can also experience pain that improves while having a period.
- Bleeding: People may notice much heavier bleeding during or between periods.
- Infertility: Individuals may have problems conceiving.
- Other symptoms: People can experience fatigue, nausea, depression, yeast infections, bloating, and dizziness.
Endometriosis is a common and painful condition that happens when tissue similar to the uterine lining grows outside of the uterus. More than 1 in 10 women experience the condition.
Ultrasound scans are valuable in diagnosing endometriosis and evaluating the severity of the condition. However, their accuracy may depend on the person performing the scan. Keyhole surgery remains the gold standard for diagnosing endometriosis.