Endometriosis: 6 reasons for late diagnosis

Endometriosis 6 reasons for late diagnosis

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    Dr Odile Bagot (Gynecologist-obstetrician)

    A chronic inflammatory disease of the female genital tract, endometriosis is increasingly better diagnosed and treated. But a delay in treatment still persists, although doctors and patients are more informed about this pathology. How to explain it? The answers from Odile Bagot, gynecologist, member of the Doctissimo expert committee.

    Endometriosis is the growth of the uterine lining, the endometrium, outside the uterus. By colonizing other organs, the mucous membrane causes disabling pain in the women who suffer from it.

    An increasingly well-known disease

    A common disease that affects around 10% of women, endometriosis has for a long time been poorly or poorly diagnosed, with some studies reporting a diagnostic gap of seven years for women on average.

    This is no longer true today” explains Odile Bagot, gynecologist and member of the Doctissimo expert committee. “The disease is better known thanks to patient associations who contributed to publicizing it and better trained doctors too.i”.

    What are the reasons that explain the delay in diagnosis in some women?

    Different reasons explain the delay in diagnosis that too many women still face today. Despite the persistent pain they feel, some patients explain that they doubt their state of health in the face of medical staff who, for their part, still too often deny their condition.

    In September 2023, a report from the Public Health Information Service revealed the different reasons explaining the delay in the diagnosis of certain women affected by endometriosis. There are in particular:

    • Misdiagnoses who delay that of endometriosis with the prescription of ultimately ineffective pain treatments. According to Odile Bagot, “painful periods that do not improve with standard treatment should suggest possible endometriosis, even if among these cases, endometriosis will not explain everything” ;
    • The presence of pain or symptoms outside the gynecological sphere. The specialist specifies that “endometriosis can colonize the abdominal area, for example, and cause atypical pain. I once had the case of a patient with neck pain. hepatic colicwhich were actually caused by endometriosis” ;
    • The presence of permanent symptoms, outside the menstrual period, would distort the diagnosis. “There is a misconception that endometriosis only causes pain during periods, but this is not true.” confirms Dr. Odile Bagot. “Deep pelvic pain during intercourse may be caused by endometriosis. ;
    • Prolonged prescription of oral contraceptives or pain treatments which could partially mask the disease for years: for the gynecologist, this is rather a false problem. “There pill is precisely the first-line treatment for endometriosis, if it allows the woman to live without pain, that is the desired goal” ;
    • Lack of awareness among general practitioners about endometriosis. According to the expert, this is less and less true: “Doctors, in general, are well aware of endometriosis and its consequences on women’s health” ;
    • The limits of imaging which does not always allow the diagnosis of endometriosis. “Medical imaging makes it possible to make the diagnosis in many cases, but not 100%.” indicates the gynecologist. “In certain cases, it is only thanks to laparoscopic surgery that the diagnosis of endometriosis can be made. But with the arrival of saliva test to make the diagnosis, it will soon no longer be useful to operate“.