Can endometriosis be diagnosed through a pelvic ultrasound?

Question

I am 17 years old and have had a significant increase in menstrual pain over the last 2 years to the point where I can barely get out of bed. My cycles are highly irregular, sometimes twice in a month, other times only once every 3-6 months. I had a pelvic ultrasound not too long ago and the doctor said that it was normal. I've been reading up on possible causes of severe menstrual pain and have come up with endo as one of the possibilities. Also, the pain is not restricted to my menstrual periods, but strewn out over the month and varying in sensations and severity.

Answer 1

I am an ultrasound technician, specializing in OB/GYN.

Ultrasound CANNOT diagnose endometriosis. Typically, it is suspected due to clinical symptoms but can only be confirmed or ruled out with a laparoscopy.

You should see a gynecologist about your pain if you haven't already. A general doctor is not the best choice in this situation. Oftentimes, a gyne will prescribe oral contraception pills to regulate menstruation and decrease pelvic pain associated with endometriosis.

Good luck.

I had to add this, because there has been misinformation given as answers to your question. Endometriosis is NOT thickening of the uterine wall. Endometriosis is when the endometrium, which is the lining of the uterine cavity (where a pregnancy implants) grows anyplace in addition to its normal locatio. For instance, in the fallopian tubes or beyond.... i.e. the pelvis. It can be very painful, since it reacts hormonally just like the normal endometrium, and bleeds just like the endometrium which is shed during menstruation. Additionally, the endometriosis causes pelvic structures (the uterus, ovaries, fallopian tubes, bowel, bladder, etc) to stick to each other, much like glue or adhesions.

Other possiblities for your pain could be:
Bladder infection or urinary tract infection
Pelvic inflamatory disease
Irritable bowel syndrome
Spinal or Muscular problems
etc

None of these possibilities, including endometriosis, usually get better without medical intervention of some kind.

However, some women suffer chronic (ongoing) pelvic pain for which the diagnosis is never confirmed.

Answer 2

Pelvic Ultrasound Endometriosis

Answer 3

No, an ultrasound cannot diagnose Endometriosis. However, it can pick up abnormal growths such as an ovarian cyst. I agree with Susan on the possibilities for your pain. I have had your same symptoms for a long time(increase in menstrual pain over time, severe menstrual pain that was not restricted to menstrual periods) and found out that I have Pelvic Inflammatory Disease(PID). I'm not saying that you have that, but it is a possibility.

But anyways back to the Endometriosis, Endometriosis is usually diagnosed by a description of your symptoms, menstrual cycle history, severity of pain, pelvic examination(although sometimes a pelvic exam may not show any signs of Endometriosis, even though a patient has Endometriosis), and through a laparoscopy procedure.

I suggest that you make a doctor appointment as soon as possible because any severe pain as you described should be addressed and treated. Your doctor may put you on a hormonal treatment(such as a birth control pill, which may relieve your symptoms) and or a prescription anti inflammatory medicine.

Answer 4

An actual diagnosis of Endometriosis can be suspected based on diagnostic imaging studies such as U/S, MRI, etc. combined with symptoms that the patient presents with; however, the diagnosis is considered uncertain without the required surgical intervention in which the disease can (in some cases) be visualized by the surgeon and (more importantly) be diagnosed via histological confirmation of ectopic endometrial glands and stroma (required for a concrete diagnosis). Endo commonly causes "killer cramps," but the symptoms are not limited to monthly cycles - many, many women with Endo (particularly those with more active disease such as the clear and flame-like vesicles) experience pain all month long with or without menstruation. There is an excellent presentation on Endo in teens which may interest you located here for free:

http://health.groups.yahoo.com/group/erc/files
then select the Girl Talk Kit.pdf file about 1/2 way down the page

You must be a member of that group to access the file, but membership is free and confidential and the group offers a wealth of info and support to patients of all ages.

There is also a corresponding "Girl Talk" group for young women who have or think they have Endo located at http://groups.yahoo.com/group/ERCGirlTalk which contains similar info and support, but in a moderated, private setting. Both groups and their materials are free.

Surgery, required for a diagnosis, is also the most effective means of treating the disease, assuming the surgeon is going to effectively remove all disease at the time of the procedure. It is important to find this out, as well as his or her full understanding of the disease, before undergoing a laparoscopy that might end up being a waste of time. Before considering other treatments such as Lupron, often offered to young women prior to surgery, see:

http://www.endocenter.org/pdf/PreDiagnosisGnRH.pdf
and
http://www.endocenter.org/pdf/surgery%20vs.%20gnrh.pdf

See also http://www.centerforendo.com for extensive info from a specialty treatment center. Good luck and know you are not alone.

Answer 5

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Answer 6

if you had a pelvic ultra sound it would have picked up endo,if i was you i would get my doctor to refer me to a gynaecologist as they speacialise in that field.