To begin the diagnosis and treatment process, your health care provider will do a thorough medical evaluation, including collecting information about your symptoms and your gynaecologic health history. Your doctor will want to know about:

• Your pain and symptoms
• Your reproductive health (age of first period, menstrual cycle frequency and regularity, pregnancy history)
• Medications you are taking or have taken
• Your family history of endometriosis or gynaecologic cancers
• Your medical history
• Your general health

A physical examination is also necessary to make a diagnosis and decide on appropriate treatment. Your health care provider will perform a pelvic examination, and possibly a rectal-vaginal examination. This enables him or her to feel for signs of endometriosis or other disorders that may be causing your symptoms.  Your doctor might perform this examination when you are menstruating, as scientific evidence suggests that this could improve the chances of detecting endometriosis.

Your health care provider may also perform an ultrasound, which can detect and other pelvic disorders that might be causing your symptoms, such as ovarian cysts or uterine fibroids. If the endometriosis is suspected to be very extensive, other non-invasive imaging tests such as a colonoscopy, cystoscopy, rectal ultrasound or MRI may be required.

In many cases, your health care provider will recommend appropriate treatment based on the information collected from your medical history (the questions above), physical exams and imaging tests. For some women, further diagnostic tests (such as laparoscopy) might be necessary. However, laparoscopy is a surgical procedure and all surgery has some amount of risk, so it is not recommended for all women. Your health care provider will usually recommend that other less invasive treatment options are tried first.