first line investigation for endometriosis

Clinical answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 1 August 2025Updated: 1 August 2025 Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

The first-line investigation for diagnosing endometriosis is a transvaginal ultrasound scan, which should be offered to all women or people with suspected endometriosis, even if pelvic or abdominal examination is normal. This ultrasound helps identify ovarian endometriomas and deep endometriosis, as well as other pathology that may be causing symptoms.

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