A frequent pathology but still poorly diagnosed
L’endometriosis touche more than 2 million women of prosecuted age in France. It manifests itself in particular by chronic pelvic painof the digestive disordersof the painful sexual intercourse or a infertility. However, she stays poorly known, poorly spottedand sometimes trivialized.
According to several studies, it takes on average 7 to 10 years Between the appearance of the first symptoms and the diagnosis. A period deemed unacceptable by patient associations, who denounce a Invisible form of this suffering.
What the now says High Health Authority
In its new recommendations, HAS clarifies the place of imaging in the diagnostic route. Until now, practices varied from one professional to another, creating Inequalities of access and quality of management. The new strategy is based on Three levels coordinated investigation, depending on the clinical situation of the patient.
Tableau : The diagnostic course recommended by the HAS
| Stage | Recommended examination | Comment / Objective |
|---|---|---|
| 1. First appeal | Endovaginal ultrasound (if trained practitioner) | First -line examination, non -invasive, simple and quick |
| 2. If doubt or failure of the 1st test | Pelvic MRI ± Additional ultrasound | To visualize deep or atypical forms |
| 3. In pre-operative | Pelvic MRI + rectal / entero-irm / coloscanner echoendoscopy | To map the lesions, adapt the surgery |
A saliva test in waiting for validation
At the same time, a Innovative saliva test is under experimentation for women in whom imaging does not allow us to conclude, despite evocative symptoms. This test, not yet integrated into official recommendations, could Modify the diagnostic strategy eventuallyprovided that it is scientifically validated and reimbursed by health insurance.
A plus taking into account global patient experience
HAS is not satisfied with technical recommendations. She also insists on The attitude of the practitionerwho must demonstrate pedagogy, benevolence and vigilance :
- Explain each examination To limit anxiety,
- Respect intimacy of the patient, especially during pelvic examinations,
- Adapt the gestures to pain and history,
- Be attentive to possible situations of sexual violencewhose frequency is higher in women with chronic pain.
This human dimension is now considered central in the quality of care.
A necessary harmonization on the territory
The recommendations also aim at Reduce regional inequalities. Today, according to the HAS, too many women undergo diagnostic delays for lack of access:
- to one Doctor trained in endovaginal ultrasound,
- to one centre expert With good imaging tools,
- or to a Coordinated network of specialists (gynecologists, radiologists, surgeons, etc.).
The HAS therefore invites the local health authorities to Structure territorialized care pathsincluding training, coordination and rapid orientation towards specialized centers if necessary.
Hope for million women
With these new recommendations, the HAS provides a concrete response to a situation often described as a “silent health scandal”. By making the course clearer, faster, more respectful, it aims at break the medical isolation of many patients.
But the stake remains immense: these directives will have to be broadcast, applied, and supported in the fieldso that the daily life of women with endometriosis is no longer defined by waiting, doubt, or misunderstanding.
Better diagnosing endometriosis is also better to treat it, better support it, and better recognize patients. An expected, late, but essential effort.
