Gynae said suspected endometriosis but won't do laparoscopy?

[Miamoo134]

Hey all!

29 y/o here and I have been having awful period pain since as long as I can remember but recently for the last year it has been managed with codeine but only 60mg dose reduces the pain to a more tolerable level.

GP's every time I visited would say to go on the pill but one day last year I just basically said I'm fed up of not knowing what is causing the pain and that it really just feels like something else is going on. I finally got referred to gynae and described all my symptoms and past medical history such as ibs and gynae basically said it's likely I have a component of endo but it would be pointless to do a diagnostic laparoscopy unless I am or will be TTC ASAP (which I am not but I am almost 30 and thinking trying in a year or so). She basically said if I am struggling to conceive then she would move forward with a laparoscopy but for now - stick to the pill. She also said even if I am diagnosed for sure, treatment would remain the same and she would offer the pill. Is this quite normal procedure or has anyone had a similar experience? I had the understanding that they could do excision of endo & then I might have less pain for a while (and this could even increase chances of fertility maybe?) but then other half of me thinks maybe she's just saving me from having a procedure when it could just be managed with the pill. But for my peace of mind I guess I wish I could have a confirmed diagnosis or ruling out. Idk - I just want to have an understanding so if anyone has any experiences or advice that would be great 😊. TIA

If you do go onto have a lap operation ensure it is not solely a diagnostic one. You should also have a follow up appointment a few days post lap to discuss the findings; accept nothing less. If endo is found it needs to be removed and not just diagnosed entailing more surgery. It also sounds like the gynae you saw is perhaps more junior, needs more training and or is not all that vastly experienced in dealing with such cases. The pill masks the symptoms of the underlying problem; it certainly won't deal with any endometriosis deposits already present.

I would also consider seeking a second opinion and from a consultant gynaecologist based in a BSGE centre. www.bsge.org.uk/centre/

Thank you for your response. I have booked an appointment for Monday and I will be telling my GP I want a second opinion. It's just frustrating having to explain it over and over to them. I really thought I had it when I finally got my gynae appt and then to be told to to go on the pill to help manage the pain just really wound me up. All signs point to it and in my letter the gynae consultant wrote:

It's more than likely that I have endometriosis and management options include depo, implant or pills etc. She also noted again it's likely to be endometriosis and if I'm unable to conceive then proceed with laparoscopy as excision of endo would be beneficial then.

I don't know what else to say or anything different except that I'm just disappointed that I've been like this for so many years and not once has anyone offered gynae. Before I was referred, I asked my GP at what point or how many years in do you think okay this now deserves a referral and an investigation. So they finally referred me.