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How do you get a diagnosis of endometriosis?

It can take several years to get a diagnosis of endometriosis. This is because symptoms vary between women, and symptoms can change over time. Also, period pain is often accepted as normal.

Early diagnosis and treatment of endometriosis will help you manage the condition and improve your quality of life.

The recommended way to see if you have endometriosis is with imaging technology, such as MRI.

On this page, you’ll learn about how endometriosis is diagnosed and when to see your doctor.

Topics on this page

Pelvic or abdominal examination

When you visit your doctor, they will ask about your symptoms and medical history. They may also suggest an internal examination to feel for things like tenderness, areas of thickening or lesions in the vagina. The examination can also help rule out other causes of symptoms.

If your doctor suspects endometriosis, you’ll be referred to a specialist for an ultrasound.

Ultrasound

In Australia, an internal ultrasound is the best way to look for signs of endometriosis. A device that records images of the pelvic area is inserted into the vagina. This gives a more accurate result than an ultrasound on your belly.

You may have the condition even if the scan doesn’t show signs of endometriosis.

Depending on the results, your doctor might recommend certain medicines to manage symptoms, or they may offer surgery. But the aim is to minimise surgery where possible.

If you can’t have an ultrasound, your doctor may recommend an MRI.

Magnetic resonance imaging (MRI)

MRI is a technology used to take cross-sectional pictures of your body. MRI scans are best reviewed by specialists in this type of imaging. The scans show how much deep endometriosis is in your body and helps inform decisions about surgery.

Laparoscopy

A laparoscopy is keyhole surgery (via the belly) performed under general anaesthetic. A laparoscopy can confirm the presence of endometrial tissue, which can be treated during the operation.

This surgery is usually performed if your doctor thinks you may have endometriosis and other treatments haven’t worked. But surgery comes with risks, so it’s important to minimise this procedure where possible.

If you choose to have surgery, look for a surgeon who has experience managing endometriosis.

Stages of endometriosis

Several staging systems have been created to show different levels and forms of endometriosis. Each system has its strengths and weaknesses.

Knowing about stages can help you understand endometriosis. But it’s important for you and your doctor to focus on your symptoms, preferences and priorities when making treatment decisions.

Revised American Society for Reproductive Medicine (rASRM) stages of endometriosis

  • Stage 1 – minimal (a few superficial implants).
  • Stage 2 – mild (more and deeper implants)
  • Stage 3 – moderate (many deep implants, small cysts on the ovaries and adhesions).
  • Stage 4 – severe (many deep implants, large cysts on the ovaries and many thick adhesions.
If you have difficulty getting pregnant, doctors can use the Endometriosis Fertility Index to help predict your chances of pregnancy following surgery.

Endometriosis in teenage years

It can take time to get a diagnosis of endometriosis when you’re a teenager. But with more awareness of the condition and its symptoms, doctors are identifying endometriosis earlier.

Symptoms such as pain before and during a period, pain between periods and nausea with pain are common in teenage years. But these symptoms may not be due to endometriosis.

If your doctor suspects endometriosis, they may recommend an ultrasound on the abdominal area to learn more.

They may suggest hormone medicines, such as the Pill or progestogen-only therapy, to help with painful periods. If symptoms don’t get better after several months of hormone medicines, doctors may suggest surgery.

Your doctor can refer you to a gynaecologist with specialist skills in treating endometriosis in teenagers.

When to see your doctor about endometriosis symptoms

Pain is a common symptom of endometriosis. But it’s not normal to have severe period pain.

If you think you have endometriosis, see your doctor as soon as possible, as early diagnosis and treatment can reduce the severity of the condition.

Your doctor may ask questions about:

  • your periods, for example, if your periods are regular and if you have heavy bleeding
  • period pain, for example, where you have pain, how long the pain lasts, if the pain stops you from doing normal activities and what medicines help to reduce the pain
  • different types of pain, for example, if you have pain during or after sex, when you go to the toilet or during ovulation
  • different types of symptoms, for example, if you have constipation, diarrhoea or bloating; lower back or leg pain; or fatigue
  • your family history, for example, if family members have had endometriosis
  • your fertility, for example, if you have tried to get pregnant.

You might also like to read our Seeing your doctor about persistent pelvic pain fact sheet.

This con­tent has been reviewed by a group of med­ical sub­ject mat­ter experts, in accor­dance with Jean Hailes pol­i­cy.

© Jean Hailes Foun­da­tion. All rights reserved.

1
Nnoaham KE, Hummelshoj L, Webster P, et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011;96(2):366-373.e8. doi:10.1016/j.fertnstert.2011.05.090
2
Endometriosis guideline. www.eshre.eu. https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Endometriosis-guideline
3
Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril. 1997;67(5):817-821. doi:10.1016/s0015-0282(97)81391-x
4
de Sanctis V, Matalliotakis M, Soliman AT, Elsefdy H, Di Maio S, Fiscina B. A focus on the distinctions and current evidence of endometriosis in adolescents. Best Pract Res Clin Obstet Gynaecol. 2018; 51:138-150. doi:10.1016/j.bpobgyn.2018.01.023
Last updated: 
16 September 2025
 | 
Last reviewed: 
31 March 2025

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