Two of the big symptoms of endometriosis that can tip off patients and doctors are debilitating pelvic pain, particularly just before and during your period, and infertility. Endometriosis can be present, and can even be serious, without showing either of these symptoms, but other symptoms of endometriosis may be more subtle or even become something you’ve learned to live with day to day.
Endometriosis can be diagnosed clinically, meaning that your history and symptoms are enough for your provider to diagnose the condition. You may have lab testing, imaging (like a pelvic ultrasound), or surgery at some point, but these don’t need to be done before the clinical diagnosis. Having to wait for these types of additional tests can be financial and logistical barriers, which can delay care and treatment for many folks.
Methods of detection
- Process of elimination: While working on diagnosing endometriosis, a healthcare provider might also want to rule out other possibilities by running blood tests or testing vaginal cultures for infection. Certain imaging, like an ultrasound or MRI may also be needed.
- Physical exam: A pelvic exam is often the first step in testing. Your healthcare provider will place two gloved fingers into your vagina and will use their other hand on your lower belly to feel for bumps (often called nodules), tender spots, and/or to feel for the mobility of your uterus and ovaries. (Endometriosis can cause scar tissue to develop that holds your uterus and/or ovaries in place abnormally) Pelvic exams only explore a small area of your body. , Not all cases of endometriosis cause nodules and adhesions, and many cases cause these issues outside of the area that can be checked during a pelvic exam., So it is important to remember that this exam can’t rule out endometriosis if nothing is found.It’s also important to keep in mind that cysts and nodules can be caused by other conditions aside from endometriosis, so although it can be a helpful starting point, a pelvic exam has limitations
- Surgery: The former gold standard for diagnosis, a laparoscopy (less invasive surgery) can actually allow your surgeon to see areas of endometriosis and how widespread they are. This is called staging. In a laparoscopy, a small incision is made near the belly-button and a surgical tool with a camera on it is used to look around, and sometimes even take a biopsy (sample) of the tissue in the pelvis. Laparoscopy can give an idea of how much endometriosis is present and where, which can help to determine the course of treatment.
Having a diagnosis makes a huge impact on your health care and treatment. It validates your experiences and challenges, can help get health insurance coverage for treatments, and gives you a path forward to relieving pain, improving fertility, and so much more.
Reviewed by the Ovia Health by Labcorp Clinical Team
Sources
- ACOG “Diagnosis of Endometriosis” Clinical Practice Guideline Number 11. March 2026. Web.
- Mayo Clinic Staff. “Endometriosis.” Mayo Clinic. Mayo Clinic, August 30 2024. Web.
- Nisenblat V, Bossuyt PMM, Farquhar C, Johnson N, Hull M. “Imaging tests for the non-invasive diagnosis of endometriosis.” Cochrane. Cochrane, February 26 2016. Web.
- “Endometriosis: A Guide for Friends, Siblings, and Significant Others.” youngwomenshealth. Boston Children’s Hospital, November 22 2023. Web.
