How is endometriosis diagnosed?

The diagnosis of endometriosis requires a comprehensive evaluation based on multiple sources of information. Clinical symptoms such as progressively worsening dysmenorrhea, chronic pelvic pain, and infertility are important diagnostic indicators. Gynecological examination, particularly bimanual examination, may reveal tender nodules or cystic masses in the pelvic cavity. Imaging studies—including ultrasound, CT, and magnetic resonance imaging (MRI)—are also valuable; especially transvaginal ultrasound, which can determine the location, shape, and size of ectopic cysts. Laboratory tests, such as measuring serum CA125 levels, can further aid diagnosis, as CA125 is often significantly elevated in severe cases. Finally, laparoscopy is considered the gold standard for diagnosing endometriosis, allowing direct visualization of suspicious lesions and enabling biopsy for histological confirmation. By integrating information from patient history, clinical presentation, gynecological examination, imaging studies, and laparoscopic findings, endometriosis can be accurately diagnosed.