Can endometriosis be decisively diagnosed by pelvic exam?

Endo. The gold standard for the diagnosis of endometriosis is laparoscopy. On a personal note in the prescence of pain with menses and significant pain when I do my exam and stretch the uterosacral ligaments, I find endo at the time of laparoscopy about 90% of the time.
Yes and no. On pelvic exam, nodules that are palpable on the ligaments that support the uterus can be highly suggestive of endometriosis especially in the setting of historic patient data (painful periods that improve while on birth control pills)...Ultimately, the "gold standard" diagnosis is visualization with laparoscopy but often times this can be misleading bc endo may not be superficially visible.

Related Questions

I had a pelvic exam to help diagnose a cyst on my left ovary and am still in pain 20 hours later. I may have endometriosis according to my new dr?

YES Endometriosis. Endometriosis usually causes chronic pelvic pain and may cause a 'cyst'. Pelvic pain with intercourse, bm, and urination commonly occurs and symptoms may be worse during periods. Periods can become heavy with bleeding in between. P.I. D. Needs to be ruled out but a laparoscopy ('scope in the belly') is the best test to get a diagnosis. Your gyn will get you the right meds hope you are better!
Could be. The most correlating symptom is severe pain with periods as a teenager. Not all patients with endo have this but most do. If this fits you, you would likely have nearly 100% chance of having endo at laparoscopy (unpublished data). We hope to have that publish soon. Many patients with endo however, have an inguinal pain syndrome called occult inguinal hernia. Need to rule this out.

Can endometriosis be determined by a pelvic exam?

Determined, no. Suspected maybe. It depends on a lot of things, including the extent and location of the endometriosis, how easy the woman is to examine (one case where being very skinny really helps), and the experience of the examiner. Good wishes.

I am 20, have long (approx 2 weeks) heavy, painful peroids and never had a pelvic exam. My mother had same issues and endometriosis, am I at risk?

Yes. Not that it's inherited but your symptoms suggest endometriosis. You need to see a good gyn physician, bleeding for 2 weeks & painful cycles are not normal. Not only do I recommend an evaluation and treatment, but this same treatment may preserve or improve your fertility for when you decide to have children. Take care.
Menses 3-4x/year. If you only have a cycle every 3-4 months, this may be another reason you have such painful cycles. The endometrium builds up and when the lining does shed (menses), the increased amount can cause prolonged & painful cycles. This also places you at risk for hyperplasia (precancerous endometrium) & you would benefit from an evaluation & hormonal rx (ocps, or Provera (medroxyprogesterone) for 10 of 30 days). Take care.

Painful periods that have gotten worse over six months, painful sex and nodules/graininess felt on pelvic exam. Does this sound like endometriosis??

Certainly possible. Endometriosis is one of the more common causes of painful periods. Often nodules can be palpated by an experienced Obgyn during a pelvic exam. Laparoscopic (surgical) evaluation is the most accurate why to confirm the diagnosis and small lesions can be removed or cauterized during the procedure.
Yes. Yes it does, find a GYN MD with the expertise to treat you.

Pelvic exams are always very painful for me. I do have endometriosis. What does this mean?

Maybe. Might be from endometriosis (when lining of uterus grows in places other than uterus) but you may also have other conditions that can cause painful examinations. Make sure you follow up with someone whom specializes in pelvic pain. Check out the Internationtal Pelvic Pain Society.
Makes sense. Those two very often go together. If you do not have a certain (surgical) diagnosis of endometriosis, painful exams doe snot mean that's what it is. Treatment of the endo is the solution to the problem. Good wishes.

I have endometriosis and pelvic exams are always very painful for me. What does this mean?

Multiple reasons. You could have multiple different reasons for pain during and after exams. You may have pelvic floor muscle spasms, vulvodynia, endometriosis, painful bladder syndrome among others. You should be carefully evaluated by pelvic pain specialist.