Endometriosis Ultrasound: What to Expect, How to Read Your Ultrasound Report, and More


You’ve suspected it for a while.

After reviewing your symptoms, your doctor has you scheduled for an ultrasound later this week.

While you’ll be grateful to get some answers, you’ve got questions.

  • How do doctors diagnose endometriosis?
  • Can an ultrasound detect endometriosis?
  • And if so, what are the signs of endometriosis on an ultrasound?

In this guide, I’ll explain the signs of endometriosis on an ultrasound, what to expect, and more.

Table of Contents

What is an Ultrasound?

While we’re all familiar with the use of ultrasound during pregnancy, it is also commonly used with endometriosis.

Also known as sonography, this diagnostic tool relies on high-frequency sound waves to see what’s going on inside your body.   

In this case, your reproductive organs.

Main Reasons to Get an Ultrasound

So, why did your doctor refer you for an ultrasound? 

It’s possible he or she may suspect endometriosis if you’ve experienced some of the following symptoms:

  • Chronic pelvic pain
  • Heavy bleeding 
  • Pain during ovulation
  • Intense menstrual cramps
  • Pain during or after sex
  • Pain when you go to the bathroom
  • Infertility

 Can an Ultrasound Detect Endometriosis?

A standard ultrasound won’t definitively reveal to your doctor whether or not you have endometriosis.  

This is because ultrasound just doesn’t have the capability to detect the small peritoneal lesions of endometriosis which are present in Stage I of the disease.

So, can an ultrasound detect endometriosis?

The answer is no.  

The only way to formally diagnose the extent and severity of endometriosis is laparoscopy.

But ultrasound is a good place to start.

How is the Ultrasound Performed?

While there are several methods of ultrasound, the transvaginal ultrasound is the preferred method when it comes to checking for signs of endometriosis on an ultrasound.

During this procedure, an ultrasound transducer, which is slightly larger than a tampon, is gently inserted into your vagina. 

The transducer then emits sound waves that bounce off of your internal organs.

By rotating the transducer, the sonographer is able to capture close-up images of your uterus, as well as all of your pelvic organs.

And while there are several methods of looking for endometriosis on transvaginal ultrasounds, the “tenderness-guided” method seems to be particularly helpful. 

Using this method, the ultrasound technician evaluates any painful areas by using the probe to apply gentle pressure.  

The benefit? 

A “tenderness guided” ultrasound gives the technician the ability to take a direct look at any painful areas inside your pelvis, while also getting your real-time feedback. 

And good news...

The procedure only lasts between 15 to 30 minutes and has been shown to be extremely safe.

3 Signs of Endometriosis on Ultrasound- Understanding Your Endometriosis Ultrasound Report

So what might your doctor see when checking for endometriosis on a transvaginal ultrasound?

1. Lesions

For starters, your endometriosis ultrasound report may show the presence of wounds, called lesions.

Lesions may be found on, or in, your:

  • Ovaries
  • Fallopian tubes
  • Peritoneum (the side-wall of the pelvis)
  • Pouch of Douglas, which is the lowest area of your peritoneal cavity
  • Rectal-vaginal septum
  • Uterosacral ligaments that connect your sacrum to your uterus

And in severe cases, lesions may be present on your:

  • Bladder
  • Intestines
  • Bowel
  • Rectum
  • Appendix

These lesions grow and bleed each month when you have your period.

While a transvaginal ultrasound can identify larger lesions, it doesn’t have the degree of resolution needed to detect smaller, superficial lesions indicative of Stage I Endometriosis.

2. Endometriomas

Endometriomas are large endometriosis cysts and can be seen during a transvaginal ultrasound. 

Commonly referred to as "chocolate cysts,” endometriomas contain a thick, brown, tar-like fluid and occur in an estimated 20 to 40 percent of women who have endometriosis.  

This form of ovarian cyst is of particular concern due to their risk of breaking and spreading endometriosis within the pelvic cavity.

3. Deep Nodules

Deep nodules, which indicate the presence of Category III or deep infiltrating endometriosis (DIE), may also show up on your endometriosis ultrasound report. 

Deep nodules may affect your:

  • Ovaries
  • Rectum
  • Uterus

They are commonly associated with:

  • Severe menstrual pain
  • Pain during or after you have sex
  • Pain with bowel movements
  • Constipation
  • Pain when you pee

What Are Other Ways to Detect Endometriosis?

Since your doctor won’t be able to see all of the signs of endometriosis on ultrasound, there are other procedures he or she may want to conduct to check for the presence of endometriosis. 

1. MRI

An MRI scan is noninvasive and has the ability to take a clear picture of the inside of your body, without using X-rays. 

Unlike ultrasound, an MRI has the capability to see small lesions, which are present in the early stages of endometriosis. 

Additionally, doctors rely on MRI test results to help prepare for surgery, should it become necessary. 

2. Laparoscopy  

Your doctor may decide to refer you to a surgeon for laparoscopy.  

During this procedure, your surgeon will make a small incision near your belly button and insert a tiny laparoscope in order to look for signs of endometriosis outside of your uterus.  

Laparoscopy can give your doctor some very specific information about the location, size, and extent of any endometrial implants.  

Your surgeon may take a tissue biopsy, which will then be used for further testing.  

Many times, the surgeon can treat the endometriosis during laparoscopic surgery, preventing the need for additional surgery.

Laparoscopy has the capability of diagnosing ALL forms of endometriosis and is the best way to diagnose endometriosis.

What Comes Next? 3 Treatment Options for Endometriosis

What if the diagnosis is endometriosis? 

Sounds pretty scary, huh?  

I know. I’ve been there.  

So what happens next?

Thankfully, you have several options for treating your endometriosis.

1. Medications

Many doctors recommend over-the-counter pain relievers and/or hormone therapies for endometriosis.  

Hormone therapies include:

Since hormone therapy isn't a permanent fix for endometriosis, you may experience a return of your symptoms if you stop treatment.

2. Natural Remedies

Personally, I’ve found amazing success by treating the symptoms holistically.  

My go-to natural remedies include: 

  • Evening Primrose oil
  • Coconut oil
  • Omega oils
  • High-quality probiotics

And don’t forget about your vaginal health

My personal moisturizer, Chiavaye, is 100% natural, vegan, and chemical-free.  

It works wonders on helping to improve vaginal elasticity and relieve vaginal dryness.

3. Diet 

We’ve all heard it.

You are what you eat.

When it comes to endometriosis, this is particularly true. 

Your diet plays a huge part in the treatment of your endo symptoms.

And while I know a change of diet can seem totally overwhelming, here are a few suggestions…

A great place to start is by only eating meats that are free of:

  • Hormones
  • Antibiotics
  • Chemicals 

And if you’re hungry for fish, always choose wild-caught.

Go gluten-free.

Skip the cow’s milk and opt for almond instead. 

And avoid soy milk and soy products since they can increase your estrogen levels.  

Lastly, be sure to cut out the sugar.  

You can do it and you’ll be amazed at how much better you’ll feel.

4. Surgery

Surgeries for endometriosis range from conservative, like the laparoscopy we talked about above, to a complete hysterectomy.  

If you think you may be suffering from endometriosis, be sure to contact your doctor.

Leave a comment

All comments are moderated before being published