Several studies have recently investigated the efficacy of blood tests and biomarkers to diagnose endometriosis. Considerably less invasive than a laparoscopy, which is typically used to confirm endometriosis, blood tests could provide a quicker and easier diagnosis.
However, many endometriosis health experts remain skeptical as to the accuracy of blood tests as a reliable diagnosis of endometriosis.
What is Endometriosis?
According to the Endometriosis Foundation of America, endometriosis is a disease that occurs when cells similar to the inner lining of the uterus, known as the endometrium, grows outside of the uterus. It is estimated to affect as many as 200 million women globally during their reproductive years and one in 10 American women.
Typically found growing on pelvic organs like the ovaries, fallopian tubes, bladder, and rectum, this abnormally growing endometrial-like tissue is equally as sensitive to hormonal fluctuations as the uterine lining. It can become inflamed and break down during menstruation but is not flushed from the body like the lining of the uterus.
As a result, this tissue can form painful ovarian cysts, tender scar tissue, and adhesions that cause organs to stick together.
Ensuing symptoms can include pelvic pain, spotting between periods, discomfort during sex, heavy menstrual bleeding, pelvic floor dysfunction, painful bowel movements, psychological distress, and infertility.
Blood Tests to Diagnose Endometriosis
Endometriosis symptoms can vary for each woman, and with the surgery required to confirm the growth of abnormal tissue outside of the uterus, many women suffer for years without a diagnosis. For these reasons, researchers began to investigate blood tests and possible biomarkers that could help diagnose the condition quicker.
Biomarkers are characteristics that can be measured in the blood, body fluids, and tissues. They are indicators of certain conditions, diseases, or normal body functions. Biomarkers can also show how well the body is reacting to treatments.
To date, over 140 research studies evaluating 122 different blood tests have been conducted. Of these, only four blood tests were considered sufficiently meaningful to provide any form of accuracy in diagnosing or ruling out endometriosis.
They included testing for:
- Anti‐endometrial antibodies
- Interleukin 6 (IL-6) - produced in response to infections and tissue injuries
- Carbohydrate antigen 19-9 (CA‐19.9) – A type of tumor marker that can be elevated with endometriosis
- Cancer antigen 125 (CA‐125) - a glycoprotein biomarker often present in women with pelvic masses such as with endometriosis
Can Blood Tests Diagnose Endometriosis?
According to the Endometriosis Foundation of America, no current blood, urine, or saliva test can successfully diagnose endometriosis. Blood tests can reveal certain biomarkers, like the blood protein CA-125 which tends to be elevated in women with endometriosis.
However, the same blood protein has also been found to be higher during menstruation, pregnancy, and other non-cancerous gynecological conditions.
For this reason, no blood test was found to be as reliable or as accurate as a laparoscopy in diagnosing endometriosis. Due to the delays that occur in diagnosing endometriosis, however, many remedies are recommended to manage the symptoms.
How is Endometriosis Diagnosed?
Currently, the only accurate method of diagnosing endometriosis is a laparoscopy. This type of keyhole surgery removes endometrial-like tissue growing outside of the uterus and tests it in a lab to confirm endometriosis. After a medical diagnosis, your provider may recommend what's called an endometriosis ultrasound.
Managing Endometriosis: What Works?
When left untreated or undiagnosed, endometriosis symptoms are often severe enough to affect women’s psychological, social, and relational well-being. A combination of treatment options can reduce the severity of symptoms and help women live with the condition more comfortably.
Treatment options for endometriosis will differ depending on whether women are trying to become pregnant or not.
For women not trying to conceive, hormone therapy is typically recommended. In these cases, birth control to prevent both menstruation and the growth of endometrial tissue can reduce some symptoms of endometriosis. Another option is prescribing gonadotropin-releasing hormone (GnRH) to stop the production of estrogen and ovulation.
Regular pelvic health physical therapy can ease many of the painful symptoms associated with endometriosis. Pelvic discomfort, pelvic floor dysfunction, and painful sex (dyspareunia), in particular. Physical therapists also recommend the practice of gentle stretches and deep belly breathing at home to continue the alleviation of pelvic pain and discomfort.
Pelvic wands can massage deep pelvic trigger points, scar tissue, and adhesions for extra relief. And vaginal dilators are widely recommended to relax tight vaginal and pelvic muscles that often lead to painful sex.
Women suffering from symptoms of endometriosis also benefit from warm baths and applying heat packs to the abdomen and lower back to reduce pelvic discomfort. When pain is particularly bad during ovulation and menstruation, over-the-counter pain medication is also helpful.
Even though a blood test would be a faster, less invasive, and cheaper way of diagnosing endometriosis, as of yet no blood test has proven accurate enough to resoundingly confirm the condition. At present, the only reliable method of diagnosing endometriosis is a laparoscopy.
Because laparoscopies are often only performed after women have suffered endometriosis symptoms for years, women’s health experts recommend managing the condition with a combination of physical therapy, deep breathing, pelvic wand massage, vaginal dilators, and warm baths.
Endometriosis Foundation of America - Endometriosis: Defining It, Recognizing It, and Treating It https://www.endofound.org/endometriosis
Endometriosis Global Forum - Blood test to diagnose endometriosis - https://endometriosis.org/news/research/blood-test-to-diagnose-endometriosis/
Web MD – What Are Biomarkers? - https://www.webmd.com/a-to-z-guides/biomarkers-overview
National Library of Medicine - Blood biomarkers for the non‐invasive diagnosis of endometriosis - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7076288/
National Library of Medicine - Correlation of CA-125 serum level and clinicopathological characteristic of patients with endometriosis - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153578/