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Invisible endometriosis
Diagnosing endometriosis: course, exams, duration
In episode 3, Carole Minker explains how the diagnosis of endometriosis takes place, the 7 clinical signs on an MRI, and why the doctor's experience is decisive.
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Summary
🔊 This program is an information program by a trained professional. This is generic advice and is not a personalized diagnosis. In all cases, we recommend that you be followed by a gynecologist and/or a midwife for individualized follow-up.
What you will learn in this episode
In this episode, Carole Minker explains how the diagnosis of endometriosis works today. An often long and complex process, which starts with clinical signs and can go all the way to new technologies such as saliva testing. You will understand what tests to ask for, who to contact, and how not to get stuck in diagnostic error.
Endometriosis takes an average of 7 to 10 years to be diagnosed. This errancy is not inevitable: understanding the stages of diagnosis allows you to move forward more quickly and ask the right questions.
The 7 clinical signs: the 7D
Diagnosis begins with a gynecological clinical examination. The doctor will look for seven specific signs, called the 7D. These signs are not enough to make a diagnosis, but they guide and alert you.
- Dysmenorrhea : pain during menstruation
- Dyskesia : pain when defecating
- Dysuria : urinary disorders or pains
- Deep dyspareunia : pain during sexual intercourse
- Chronic pelvic pain : pain in the lower abdomen outside of menstruation
- Intermenstrual pain : remember that 80% of affected women have it
- Disfertility : infertility
And 25% of women with endometriosis have no pain, so they won't have any of these signs. The 7Ds are indicators, not a diagnostic grid. There is no hard and fast rule on how many signs to have. A woman may present only one, or several at the same time. And some women with endometriosis have no pain, so they won't have any of these signs.
💡 Key figures
In France, the diagnosis of endometriosis takes an average of 7 years according to the Pasteur Institute.
Source: Pasteur Institute, 2024
Ultrasound and MRI
The next step is ultrasound, ideally endovaginal. But when sexual intercourse is painful, or even tampons are impossible to wear, the probe cannot always be inserted. An abdominal ultrasound is then performed.
What counts above all is the practitioner's experience. A doctor who is very experienced with an ultrasound will always be more effective than a practitioner who is not very trained with an MRI. Interpretation takes precedence over the tool.
Pelvic MRI is the next step, but not all women have easy access to it. Carole shares the case of one of her patients who was refused an MRI several times, despite the fact that this examination could have refined the diagnosis before the operation. If symptoms appear to be localized elsewhere in the body, an MRI focused on this area may be necessary, such as a chest MRI, for example.
Superficial endometriosis remains difficult to see even with MRI. And two doctors can sometimes disagree on the same diagnosis. Taking a second or even a third opinion is entirely possible and sometimes essential.
Endotest: a new diagnostic approach
In France, when the classical exams did not make it possible to conclude, there is a third-line option: the Endotest. It is a saliva test that assays microRNAs, markers linked to epigenetic dysfunctions associated with endometriosis. The saliva is stable, the sample is simple and painless, and the results arrive in one to three days.
In France, this test comes as a last resort. In other countries, such as Canada, it is used as a first line. If you have access to this Endotest, Carole recommends doing it: it is not invasive and it can considerably shorten the diagnostic process.
Other techniques are under development: blood tests, artificial intelligence tools that interpret ultrasound or MRI images in a few seconds. The diagnosis of endometriosis is changing rapidly.
🔎 Useful definitions
Dyspareunia : pain felt during or after sexual intercourse. When they are deep, they are among the clinical signs pointing to endometriosis.
Endotest : saliva test that doses microRNAs associated with the epigenetic dysfunctions of endometriosis. In France, it is used as a third line of diagnosis. In some countries, it is offered as a first line.
🎯 Actions concrètes
- Identify if you have one or more of the 7D's. Dysmenorrhea, dyskesia, dysuria, profound dyspareunia, chronic pelvic pain, intermenstrual pain, infertility. A single sign is enough to talk to a doctor.
- Consult a gynecologist or radiologist specialized in endometriosis. A doctor, not a midwife or endocrinologist, can make the diagnosis. The practitioner's experience is decisive.
- Request an endovaginal ultrasound as a first line, followed by a pelvic MRI if necessary. Do not hesitate to insist on getting these exams if your condition warrants it.
- Don't stay with a doctor who doesn't listen. You can change your doctor at any time, ask for a second or third opinion. Nobody is forcing you to stay there.
- If you have access to the Salivary Endotest, talk to your doctor. In France, it arrives as a last resort. In other countries, it may be offered earlier in the course
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Summary
🔊 This program is an information program by a trained professional. This is generic advice and is not a personalized diagnosis. In all cases, we recommend that you be followed by a gynecologist and/or a midwife for individualized follow-up.
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⭐ La série Invisible endométriose est possible grâce à la participation de Norsan. L'épisode Bonus leur est dédié, et vous en apprendrez plus sur les Oméga 3 dans l'épisode 9. Norsan, entreprise spécialiste en production d'Oméga 3 depuis 2013 sont le plus grand distributeurs d'Oméga 3 en pharmacie car leur Oméga 3 naturels et de haute qualité font partie aujourd'hui des meilleurs Oméga 3 disponibles sur le marché.
What you will learn in this episode
In this episode, Carole Minker explains how the diagnosis of endometriosis works today. An often long and complex process, which starts with clinical signs and can go all the way to new technologies such as saliva testing. You will understand what tests to ask for, who to contact, and how not to get stuck in diagnostic error.
Endometriosis takes an average of 7 to 10 years to be diagnosed. This errancy is not inevitable: understanding the stages of diagnosis allows you to move forward more quickly and ask the right questions.
The 7 clinical signs: the 7D
Diagnosis begins with a gynecological clinical examination. The doctor will look for seven specific signs, called the 7D. These signs are not enough to make a diagnosis, but they guide and alert you.
- Dysmenorrhea : pain during menstruation
- Dyskesia : pain when defecating
- Dysuria : urinary disorders or pains
- Deep dyspareunia : pain during sexual intercourse
- Chronic pelvic pain : pain in the lower abdomen outside of menstruation
- Intermenstrual pain : remember that 80% of affected women have it
- Disfertility : infertility
And 25% of women with endometriosis have no pain, so they won't have any of these signs. The 7Ds are indicators, not a diagnostic grid. There is no hard and fast rule on how many signs to have. A woman may present only one, or several at the same time. And some women with endometriosis have no pain, so they won't have any of these signs.
💡 Key figures
In France, the diagnosis of endometriosis takes an average of 7 years according to the Pasteur Institute.
Source: Pasteur Institute, 2024
Ultrasound and MRI
The next step is ultrasound, ideally endovaginal. But when sexual intercourse is painful, or even tampons are impossible to wear, the probe cannot always be inserted. An abdominal ultrasound is then performed.
What counts above all is the practitioner's experience. A doctor who is very experienced with an ultrasound will always be more effective than a practitioner who is not very trained with an MRI. Interpretation takes precedence over the tool.
Pelvic MRI is the next step, but not all women have easy access to it. Carole shares the case of one of her patients who was refused an MRI several times, despite the fact that this examination could have refined the diagnosis before the operation. If symptoms appear to be localized elsewhere in the body, an MRI focused on this area may be necessary, such as a chest MRI, for example.
Superficial endometriosis remains difficult to see even with MRI. And two doctors can sometimes disagree on the same diagnosis. Taking a second or even a third opinion is entirely possible and sometimes essential.
Endotest: a new diagnostic approach
In France, when the classical exams did not make it possible to conclude, there is a third-line option: the Endotest. It is a saliva test that assays microRNAs, markers linked to epigenetic dysfunctions associated with endometriosis. The saliva is stable, the sample is simple and painless, and the results arrive in one to three days.
In France, this test comes as a last resort. In other countries, such as Canada, it is used as a first line. If you have access to this Endotest, Carole recommends doing it: it is not invasive and it can considerably shorten the diagnostic process.
Other techniques are under development: blood tests, artificial intelligence tools that interpret ultrasound or MRI images in a few seconds. The diagnosis of endometriosis is changing rapidly.
🎯 Concrete actions
- Identify if you have one or more of the 7D's. Dysmenorrhea, dyskesia, dysuria, profound dyspareunia, chronic pelvic pain, intermenstrual pain, infertility. A single sign is enough to talk to a doctor.
- Consult a gynecologist or radiologist specialized in endometriosis. A doctor, not a midwife or endocrinologist, can make the diagnosis. The practitioner's experience is decisive.
- Request an endovaginal ultrasound as a first line, followed by a pelvic MRI if necessary. Do not hesitate to insist on getting these exams if your condition warrants it.
- Don't stay with a doctor who doesn't listen. You can change your doctor at any time, ask for a second or third opinion. Nobody is forcing you to stay there.
- If you have access to the Salivary Endotest, talk to your doctor. In France, it arrives as a last resort. In other countries, it may be offered earlier in the course
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