How To Diagnose Endometriosis: A Guide For Women In Singapore

Endometriosis is a chronic condition affecting millions of women worldwide, including many in Singapore. It is estimated that endometriosis affects around 20-30% of women of the reproductive age group in Singapore. This condition occurs when tissue similar to the lining of the uterus grows outside the womb, causing pain, discomfort, and in some cases, fertility issues. Early diagnosis and treatment are crucial for managing endometriosis effectively. In this guide, we provide a detailed guide on how endometriosis is diagnosed in Singapore.

Understanding Endometriosis

Endometriosis is a condition where the tissue that normally lines the inside of the uterus (endometrium) starts to grow outside it, often on the ovaries, fallopian tubes, and other areas within the pelvis. This misplaced tissue behaves as it would during the menstrual cycle—thickening, breaking down, and bleeding. However, since it has no way to exit the body, it becomes trapped, leading to inflammation, pain, and the formation of scar tissue.

Symptoms Of Endometriosis

The first step in diagnosing endometriosis is recognising the symptoms. While the severity of symptoms varies, common signs include:

• Pelvic pain – Often associated with menstrual periods, this pain may begin before your period and extend several days into it.
• Pain during intercourse – Pain during or after sex is common with endometriosis.
• Pain with bowel movements or urination – These symptoms are most likely to occur during your period.
• Excessive bleeding – You may experience occasional heavy periods or bleeding between periods.
• Infertility – Endometriosis is sometimes first diagnosed in those seeking treatment for infertility.
• Other symptoms – Fatigue, diarrhoea, constipation, bloating, and nausea are also common, especially during menstrual periods.

If you are experiencing these symptoms, it is essential to consult a healthcare provider.

Consulting A Healthcare Provider In Singapore

In Singapore, diagnosing endometriosis begins with a visit to a general practitioner (GP) or gynaecologist. The doctor will start by taking a detailed medical history, focusing on your menstrual cycle, pain levels, and any other related symptoms. They will also ask about your family history, as endometriosis can be hereditary.

Diagnostic Methods For Endometriosis

Diagnosing endometriosis can be challenging as the symptoms overlap with other conditions, such as pelvic inflammatory disease (PID) or irritable bowel syndrome (IBS). The following diagnostic methods are commonly used:

1. Pelvic Examination

During a pelvic exam, the doctor will manually feel for abnormalities, such as cysts or scars behind the uterus. However, small areas of endometriosis are difficult to feel, making this a preliminary step rather than a definitive diagnosis.

2. Imaging Tests

• Ultrasound: A transvaginal ultrasound or pelvic ultrasound may be used to check for endometriomas (ovarian cysts associated with endometriosis). While ultrasound would not definitively diagnose endometriosis, it can identify cysts that warrant further investigation.
• MRI (Magnetic Resonance Imaging) -In some cases, an MRI scan is recommended to get a detailed picture of the organs and tissues. This can help in planning surgery if required.

3. Laparoscopy

The most definitive way to diagnose endometriosis is through a laparoscopy, a minimally invasive surgical procedure. During this procedure, the surgeon inserts a thin tube with a camera (laparoscope) into the abdomen to view the endometrial tissue outside the uterus. If endometriosis is detected, it can often be treated or removed during the same procedure. Laparoscopy not only confirms the diagnosis but also assesses the extent and severity of the condition.

4. Biopsy

During a laparoscopy, the surgeon may take a tissue sample (biopsy) to be examined under a microscope to confirm the presence of endometrial cells.

Post-Diagnosis: What To Expect

If you are diagnosed with endometriosis, your healthcare provider will discuss treatment options based on the severity of your symptoms and your future plans, such as whether you are trying to conceive. Treatment may include:

• Medication – Pain relief medications, hormone therapy, or both may be prescribed to manage symptoms.
• Surgery: – In severe cases, surgery to remove as much endometrial tissue as possible may be recommended, especially if you are experiencing fertility issues.
• Lifestyle Adjustments – Diet, exercise, and stress management can play a significant role in managing endometriosis symptoms.

Managing Endometriosis In Singapore

Living with endometriosis requires ongoing management. Singapore offers various resources, including specialised clinics and support groups, where you can find help and connect with others facing similar challenges. Regular follow-ups with your healthcare provider are essential to monitor the condition and adjust treatment as needed.

Key Takeaway

Diagnosing endometriosis involves recognising the symptoms, consulting with a healthcare provider, and undergoing a series of tests, including possibly a laparoscopy, to confirm the condition. Early diagnosis and intervention are key to managing endometriosis effectively and improving your quality of life.

Where To Get Diagnosis In Singapore

If you are in Singapore and suspect you may have endometriosis, do not hesitate to seek medical advice. Proper diagnosis and treatment can significantly alleviate the symptoms and help you lead a healthier life.

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