Diagnosis of Endometriosis

Physical Exam and History:

At the time of the initial visit, your doctor will ask about the symptoms and risk factors listed above. Your physical exam may be normal, or you may have pain or tenderness when the doctor presses down on the ovaries or the uterus. Rarely, your doctor may be able to feel small nodules that correspond to endometrial implants. Often, the combination of history and any physical findings is enough for your doctor to make a presumptive diagnosis of endometriosis and begin a course of treatment. If that treatment is ineffective, or if your symptoms are severe, additional tests may be necessary.

Imaging tests:

  • Ultrasound – Ultrasound is a medical imaging test that uses sound waves to create pictures of the internal structures of the body. Transvaginal ultrasound, performed with an ultrasound probe that enters the vagina, is useful for visualizing endometriomas, mass-like collections of endometrial tissue in the ovary. Ultrasound can also detect obstruction of the kidneys.
  • MRI (Magnetic Resonance Imaging) – An MRI uses magnetic fields and radio waves to create very detailed pictures of the internal structures of the body. MRI can detect up to 78% of endometrial implants, and gives a better estimation of the extent of endometriosis than ultrasound.2


Laparoscopy, also called minimally invasive surgery or ‘keyhole surgery’, involves the introduction of a special camera through small incisions in the skin. Laparoscopy is the ‘gold standard’ or most definitive means of diagnosing endometriosis, since the implants are directly visualized. Due to its invasive nature, laparoscopy is usually reserved for suspected cases of moderate to severe endometriosis, when doctors expect to both diagnose and treat the implants within the same procedure.