Many of the symptoms of endometriosis are also the symptoms of other conditions – particularly other gynecological conditions – and therefore endometriosis is easily confused with them. These include pelvic inflammatory disease (PID), irritable bowel syndrome, ovarian cysts, appendicitis, ectopic pregnancy and occasionally cancer.
Pelvic inflammatory disease
Pelvic inflammatory disease, often known as PID, refers to any infection of the pelvic organs including the ovaries, fallopian tubes, uterus and cervix. Symptoms may include painful menstrual cramps, pain during or after intercourse, bleeding between periods, painful bowel movements or urination, generalized pelvic pain, lower back pain, nausea, fatigue, slight temperature and infertility.
PID is the condition which is most commonly confused with endometriosis when the diagnosis is made without the use of a laparoscopy because the symptoms of the two conditions are so similar. However, PID is caused by bacteria and it can be successfully treated with antibiotics. If antibiotic treatment fails to relieve the symptoms, further investigations should be carried out.
Irritable bowel syndrome
The term irritable bowel syndrome is sometimes used to describe a range of bowel symptoms when no other diagnosis can be found. The symptoms may include chronic lower abdominal pain which may be relieved by a bowel action, bouts of diarrhea and constipation, flatulence (wind), straining to have bowels opened, bloated abdomen, chronic backache, lethargy, nausea and heartburn.
Many women are diagnosed as having irritable bowel syndrome before endometriosis is finally diagnosed.
Simple ovarian cysts
A cyst is a growth that contains fluid and is enclosed by a membrane. There are many types of ovarian cysts, the most common are follicular and luteal cysts. A follicular cyst is a fluid-filled cyst which has developed from an ovarian follicle that has continued to grow and enlarge. A luteal cyst is one which has developed from a corpus luteum which has enlarged and become filled with fluid or, occasionally, blood.
The symptoms of ovarian cysts include abdominal pain on the affected side, pain with intercourse, abdominal swelling, fullness or discomfort and irregularities in the menstrual cycle. If the cyst is large it may put pressure on the adjacent organs, such as the bowel or bladder, which in turn may cause some discomfort with bowel movements or when passing urine.
Many follicular and luteal cysts disappear within a few weeks as they are reabsorbed by the body. If the symptoms persist, a laparoscopy is the only way to distinguish between an ovarian cyst and an endometrioma.
Acute appendicitis is an inflammation of the appendix and the symptoms include sudden and severe right-sided abdominal pain, nausea and vomiting, malaise and a raised temperature.
The symptoms of acute appendicitis are sometimes confused with those experienced by a woman with endometriosis where a large cyst, usually an endometrioma, has burst.
An ectopic pregnancy occurs when a fertilized ovum implants itself in an abnormal location outside the uterus, usually within a fallopian tube, and continues to develop. Because the fallopian tube cannot expand to accommodate the developing foetus the tube eventually ruptures. The symptoms experienced when an ectopic pregnancy ruptures a fallopian tube include severe left or right-sided abdominal pain, nausea and/or vomiting, vaginal bleeding and internal bleeding which can lead to shock.
The symptoms of a ruptured ectopic pregnancy may sometimes be confused with those experienced by a woman with endometriosis who has a ruptured large endometrial cyst. A diagnostic laparoscopy is necessary to determine the correct diagnosis.
The two main forms of cancer that may possibly be confused with endometriosis are ovarian cancer and rectal cancer. The symptoms of ovarian cancer include pelvic pain, weight loss, weakness and anemia, while the symptoms of rectal cancer include constipation, bleeding from the rectum and backache.
However, ovarian and bowel cancer are very rarely confused with endometriosis. If mere is any possibility that you may have cancer, diagnostic tests will be carried out quickly and thoroughly.