Transvaginal ultrasound or MRI can help identify ovarian cysts (endometriomas) or deep infiltrating lesions.

Chronic pelvic pain that may come and go throughout the cycle. Heavy or irregular menstrual bleeding. Infertility or difficulty conceiving.

Fatigue, bloating (sometimes called "endo belly"), and gastrointestinal issues like diarrhea or constipation.

This "keyhole" surgery remains the only way to definitively confirm a diagnosis through a biopsy.

Recent guidelines emphasize , meaning doctors may start treatment based on your symptoms rather than waiting for surgery.