Believe me you are not the only one who has terrible pain with vaginal penitration. I have terrible pain as well ! I've had several surgeries over the years to remove endometrial cysts and one surgery that removed my fallopian tubes.

You should try to find a pelvic floor physical therapist. Maybe ask the physical therapist if you can start with external work and then move to internal work. Here is something I found on endometriosis: "Women with endometriosis may have issues with the muscles inside the pelvis. This is called pelvic floor dysfunction. Women with endometriosis can also have trigger points within the muscles of the pelvic floor. When a tiny fiber of a muscle or tissue stays contracted but the rest of the area does not, you can get an area of hypersensitivity called a trigger point. The trigger point can cause pain elsewhere from its location. Your trigger point may be inside your pelvis but it could cause lower abdominal or rib pain."

I have pelvic floor dysfunction in a big way. Have been trying to work on my health issue but challenged by the money/time issue. When I am working I have no time and no energy. When I am not working I have time but no money to get physical therapy and eat healthier organic food. I often struggle with being too tired to cook. I do somethings with a slow cooker sometimes.

I also get huge blood clots. Not sure what that is about. Sometimes at work I will be standing there and I can feel a huge gush of blood and then my pad is soaked. I showed my husband the size of a clot one day and he thought I could have miscarried. i thought that isn't possible because I no longer have my Fallopian Tubes.

They do have something called conscious sedation and the degree of sedation they give you can vary. Having said that the only way they can truly diagnose endometriosis is laprascopy and I was never awake for mine. Could they give you an epidural and then do the procedure? You wouldn't be going to sleep? I know that some ob gyn's will write you a vaginal valum script that might help make these procedures more tolerable. There is also this book called Heal Pelvic Pain and if you pop that into Amazon I think there is another book written by a pelvic floor physical therapist you can use at home. I know a vaginal ultrasound can definitely identify some things with endometriosis but if you want some knd of pain management you would probably have to go to a surgical center and get the epidural or discuss some other pain management options because I know there are conscious sedation options for dentistry through pills or iv sedation where people are still awake.

I'm sorry for what your going through. And sorry for what you have been through. I wish I was educated enough to give u some answers. And I hope things get better for you. I am terrified of being put to sleep and they gave me some medication that made me totally relaxed, too relaxed lol and the anaesthesia was much easier this time. It's been 9'days since my surgery.
And before my surgery I was in pain probably around 3 weeks out of 4...
even after this if I get two weeks out of 4 being well il be greatful. I can't imagine a life pain free. But I need to give my body chance to recover.

If you are Peri menapoaseal ur on your way to getting better I believe. According to what my doctors have told me. They have told me that if they gave me an injection to iduce early meanapause it would relieve my pain.. so maybe you could ask about the injections and see if he thinks they could help with your pain? even if it's just to push you into full blown Menopause rather than half way there. I'm sure your aware periM can go on for years.... I'm no expert it's just an idea. I'm not medically trained and I havnt looked too deep into things. I just go with the flow and learn as I need to.

Hope some part of my comment helps.
Good luck xx