Here’s why so many doctors drop the ball on diagnosing endometriosis

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Doctor Rich:

Welcome back to the Dr. Rich channel — and thank you for helping us reach a thousand subscribers! If you haven’t had a chance, hit the subscribe button now. This month, we’re answering subscriber questions. Viewer Jing asks, “Why do so many doctors drop the ball on diagnosing endo?” Today, we’ll talk about why doctors miss the diagnosis — and we’ll also talk about what symptoms of endometriosis are being overlooked. Make sure to read until the end to learn what to do when the doctor says there’s nothing wrong — but YOU know there’s more to the story.

Don’t have time to read this post? Watch the video here instead!

Jing brings up a great point, and her story is all too common. She has severe pains — that even require a time off from work and school (as endometriosis does). She was told she might have endometriosis, and then after some screening, she was told that she doesn’t. 

This brings up a very important point: imaging, ultrasound, MRI — these do not show endometriosis. That’s not the reason that they’re done. Some patients don’t understand that —  and some doctors don’t understand that! Endometriosis is basically scarring. And as with all types of scarring, they’re not going to show up on an imaging study. We do the imaging studies to rule out other conditions — things we CAN see on the study: fibroids, ovarian cysts, hernias. 

Now, when we do the imaging and we don’t find another explanation for the pain — then that actually makes the endometriosis more likely, not less likely. And this underlines the point that you need to find a specialist. You need to find someone who knows exactly what to look for, and who asks the right questions. 

So what are the signs of endometriosis that might be overlooked? Well, many of the things that she mentioned! In fact, missing time from school and work is a red flag — I mean, that’s a hallmark for endometriosis, and it indicates that there’s more than just regular period cramps going on. Also, in her case, she has anemia and fatigue. And these are also common signs of someone who’s bleeding a lot on their period that can be related to endometriosis. But other symptoms of endometriosis that are often overlooked and misdiagnosed are painful bowel movements (particularly, painful bowel movements while you’re on your period) — or even bloody stools. Also, urinary urgency, or having to run to the bathroom or go more frequently during the period. These conditions are sometimes labeled as irritable bowel syndrome, or interstitial cystitis, or urinary tract infections — and they might be! But they also have a high chance of being related to endometriosis, and this needs to be worked up. 

So here’s what to do if you’re told there’s nothing wrong, you still have pain, and you feel that there’s more to this story. Get all of the workups, all of the documents — and you’re going to find a specialist

The other thing you have to do…… is have an open mind. There may be something else going on that you haven’t thought about, and you need to allow your practitioner to explore those options to best serve you. And number three: have patience! This is a process, and even the best diagnosticians can take many visits to come to a solution that’s going to get you better. 

So hang in there, there is hope, and you will get better. 

Thank you, Jing, for sparking this conversation with your insightful comment! And a shout out to all of our viewers out there. Take a moment to subscribe, and leave a comment for a chance to be featured in one of our next videos.