The diagnosis of endometriosis is first suspected by taking a history of the woman’s symptoms.

Many women have been led to believe that pelvic pain, period pain and sexual discomfort are a woman’s ‘lot in life’ or are exaggerated Despite adequate information and knowledge of endometriosis some doctors still have this attitude and the final diagnosis can be delayed for many years while the woman continues to suffer.

The diagnosis relies on a doctor taking a thorough history, performing an appropriate examination and suspecting endometriosis. The only sure way to diagnose it is to actually see the endometriosis through a laparoscope.

The examination for endometriosis is best done by a gynaecologist who performs a vaginal ultrasound at the same examination. This allows the gynaecologist to see the most painful spots. Ultrasound cannot show most types of endometriosis but it will detect the ‘chocolate cysts’ of endometriosis inside the ovary. This is crucial information.

Blood tests for endometriosis are not reliable.

Symptoms of Endometriosis

Not everyone who has endometriosis has all the symptoms listed, but any of them may be present:


  • Painful periods. The pain usually starts several days before the period begins, but can sometimes occur during the period only
  • Painful bowel motions
  • Pain during or after sexual intercourse
  • Other pain:
  • Abdominal pain
  • Leg/thigh pain
  • Back pain

Period problems

  • Heavy bleeding
  • Bleeding in between periods
  • Irregular cycles

Bowel problems

  • Bleeding from the bowel
  • Painful bowel motions
  • Diarrhoea and/or constipation

Bladder problems

  • The need to pass urine frequently
  • Pain on passing urine

Sexual discomfort


  • Delay in getting pregnant

Other symptoms/problems

  • Lethargy
  • Irritability
  • Depression
  • Poor performance at work because of pain
  • Absenteeism because of pain