A normal ultrasound does not rule out every form of endometriosis. Imaging can provide useful information, but the result needs to be considered alongside your symptoms and medical history. If symptoms continue, ask what the findings mean for your individual situation rather than treating “normal” as the end of the discussion.
The ESHRE patient guideline explains that endometriosis may still be present despite normal ultrasound or MRI findings. That does not mean everyone needs surgery: further assessment and management depend on the clinical picture.
Start with the written report
Ask for a copy of the scan report and take it to your appointment. If you have had more than one scan, bring the earlier reports as well. You do not need to interpret the medical terminology yourself.
Useful questions include: “What was the scan looking for?”, “Were there any findings that need follow-up?” and “Which possible causes of my symptoms remain?” These questions focus on what the test has added, without assuming that it can answer everything.
Explain what is still happening
Describe the symptoms that continue and their effect on daily life. Note their timing, any relationship to your cycle, and whether treatment has helped. Mention symptoms you may find uncomfortable to discuss, including pain with sex or bowel symptoms.
If pain has changed suddenly or become severe, tell the clinician clearly. A previous normal test is not a reason to ignore new or worsening symptoms.
Discuss options before agreeing to the next test
Ask what further assessment is being considered and how it might change the plan. If laparoscopy is discussed, ask about its purpose, alternatives, possible risks and recovery. It is a clinical decision, not an automatic requirement after one scan.
Before leaving, establish when to return and what should prompt earlier help. Keeping copies of reports and a short symptom history can make later appointments easier.
For related information, see how to describe pelvic pain, our laparoscopic surgery service and the practice contact page. Dr Timmal consults at Isipingo and St Augustine’s Hospitals.
Further reading
Sources checked on 18 September 2026. General patient information; individual assessment may lead to different advice.