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How has Endometriosis Typically Been Diagnosed?
Jonathan Eilberg • March 20, 2025

Endometriosis is typically diagnosed through a combination of medical history, physical examination, imaging, and sometimes surgical procedures. Below is a a step-by-step breakdown of how diagnosis usually occurs.

Endo Test being reviewed with a patient

1. Medical History and Symptoms Discussion:

  • A healthcare provider will start by taking a detailed medical history, discussing symptoms like:
  • Pelvic pain, particularly severe menstrual cramps.
  • Pain during or after sex.
  • Chronic lower back or abdominal pain.
  • Painful bowel movements or urination during menstrual periods.
  • Infertility issues.
  • Heavy or irregular menstrual bleeding.
  • Change in bowel habits, nausea, bloating

2. Physical Examination:

  • A pelvic exam might be performed to feel for abnormalities like cysts or scars behind the uterus. However, endometriosis can be deep-seated and not always palpable during a routine exam.

3. Imaging Tests:

  • Ultrasound: A transvaginal ultrasound can sometimes detect ovarian endometriomas (chocolate cysts) or large areas of endometriosis. However, it's not effective for diagnosing mild endometriosis which makes up 85% of disease.
  • MRI: Magnetic Resonance Imaging can be more detailed than ultrasound, particularly useful for identifying deep infiltrating endometriosis or endometriomas, but it's not conclusive for early forms of the disease.

4. Laparoscopy:

  • This is considered the current standard of care for definitive diagnosis:
  • Procedure: Laparoscopy involves making small incisions in the abdomen through which a laparoscope (a thin tube with a camera) is inserted to view the pelvic organs. 
  • Visual Confirmation: The surgeon looks for endometrial tissue outside the uterus, which can appear as dark spots, powder burns, or red implants. However, endometriosis can be anatomically hidden and not always visible.
  • Biopsy: After the surgeon visually localizes the disease, biopsies of suspicious tissue is surgically removed during laparoscopy and sent to pathology lab for histological confirmation, although, depending on degree of disease infiltration, visual inspection is can be sufficient for diagnosis.

5. Less Common Methods:

  • CA-125 Blood Test: Sometimes used, but not specific or sensitive enough for diagnosing endometriosis alone, as levels can be elevated in other conditions too.

6. Diagnostic Challenges:

  • 85% of Endometriosis can be very subtle and not visible on imaging or even during laparoscopic surgery if the disease is minimal or very deep and hidden within tissues.
  • Symptoms can mimic other conditions like IBS, PID, or even appendicitis, leading to diagnostic delays.
  • Disease can be difficult to localize, particularly if situated outside the pelvic cavity. 


The diagnosis of endometriosis often involves ruling out other causes of similar symptoms. Due to the invasive nature of laparoscopy, it might be reserved for cases where conservative treatments fail or when there's a high suspicion of endometriosis, especially in cases dealing with infertility. If you suspect you might have endometriosis, consulting with a gynecologist or a specialist in endometriosis should be the next step.


Good News on the Horizon

EndoSure, through its groundbreaking platform from ENDOSURE, INC., promises to usher in a new era of hope and empowerment for the endometriosis community. With its revolutionary ENDOSURE TEST—the only non-invasive, 30-minute diagnostic tool offering exceptional accuracy—this transformative innovation aims to improve the lives of millions of women worldwide. For far too long, the journey to an endometriosis diagnosis has been marred by delays, averaging 8.6 years, invasive procedures like laparoscopy, and dismissed symptoms, leaving countless individuals to suffer in silence. The ENDOSURE TEST seeks to dismantle these barriers by providing a rapid, painless, and highly reliable alternative that detects endometriosis at all stages, anywhere in the anatomy in patients of any age using cutting-edge electroviscerography (EVG) technology to identify a unique biomarker or myoelectrical "fingerprint" idiosyncratically associated with the presence of the disease.

The hope EndoSure brings is multifaceted: it offers the promise of early detection, enabling timely and targeted treatment to minimize disease progression and alleviate debilitating symptoms like chronic pelvic pain and infertility. By empowering physicians with objective data in mere minutes, it shifts the diagnostic paradigm from uncertainty to clarity, sparing women the physical and emotional toll of prolonged uncertainty or unnecessary surgeries.

Beyond individual relief, EndoSure’s commitment to raising awareness and expanding global access—evidenced by partnerships with distributors across the UK, Nordic countries, and beyond—ignites a collective hope for systemic change. This is a beacon for a future where endometriosis is no longer a silent epidemic, but recognized as a serious disease met with swift, compassionate, and effective treatment options, restoring quality of life and dignity to those affected. Post treatment, the ENDOSURE TEST can also be used to monitor treatment efficacy as well as to discover if the disease has returned.


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