Also recommend getting different opinions. I've been to about 8 OBGYNs since 2016 before one finally brought up endometriosis. I wasn't diagnosed with a laparoscopy, but she considered all my symptoms, my relatively normal hormone panels and existing PCOS diagnosis. I get ultrasounds every 6-9 months for PCOS and the uterine lining portion always comes back 'normal'.

I also think when I was able to better articulate some of the digestive issues that accompanied my period pain (or any issues that may not align with typical 'pms') is when they considered endo a bit more seriously rather than just writing down dysmenorrhea and leaving it at that.

I was definitively diagnosed with a laparoscopic surgery and biopsy in 2017. Pain has returned this year and a new OBGYN has diagnosed it again as endometriosis without any tests. She said that many doctors want to limit surgery as the defining modality for confirming endometriosis. And many ultrasound, CT scans, and MRIs can be just normal because the plaques can be hard to see unless you have a huge cyst or adenoma. They’d rather have you try hormonal therapy to see if that alleviates the pain and look at the overall picture of the symptoms you are feeling to lean toward an endometriosis diagnosis. That’s my experience with the new method of diagnosing especially since I’ve already had a laparoscopy. If you think it might be more than what your doctor thinks, get a second or even third opinion. It’s always good to get a variety of info from your regular GP, an OBGYN, and or a functional/naturopathic doctor.