Ultra sounds do not show endo. The only way to know for sure if That is what is going on inside is to have a laparoscopy procedure, to look inside . Hope that helps.

My ultrasounds were always clear showed nothing my doctor thought I was perfectly fine even though I would be in so much pain.
How I actually was able to be diagnosed was through an ER doctor who knew about endometriosis. He then referred me to a obgyn. He put me on visanne right away which helped me with the pain and then scheduled an exploratory surgery which he was able to find endometriosis as well as cysts

My ultrasounds never showed Endo, but did show a cyst growing on my left ovary. My GYN at the time found my endo when I needed a larascopy to remove the cyst becuase it had grown to 6.5cm. This size is cause for concern. Recently whenI needed an MRi to rule out an ovarian neoplasm, endo showed up on my C-section scar.

There are 3 distinct types of endo. Cystic is the easiest one to convince a doctor because they tend to grow HUGE endometriomas, but there is also deep infiltrating and peritoneal superficial endo.

I was complained of symptoms, my doctor told me I most likely did have endo BUT he wanted to "save me a surgery" because it's often "microscopic and unable to be found anyway". (insert eye roll here) A couple years later, endometriomas popped up in a well woman checkup. The doctor were concerned I had ovarian cancer, but thankfully no, just huge endometriomas and I lost my left ovary. Cystic (or ovarian endometriosis) is the easiest one to diagnose in my experience because it DOES show up on imaging, sometimes.

I was diagnosed with stage 4 and aside from the endometrioma (7 cm, which is huge) nothing else showed up on many ultrasounds or MRIs. At the minimum, I have ovarian (cystic) and deep infiltrating (which they want you to believe is rare but I don't think it is) but I think I have all three. Every appointment after my operation, my doctor would say "you have a LOT going on in there.. a LOT". I saw another doc in the practice months later and she told me she knew about my surgery because she was in surgery the same day and my doctor had told her about all he found. I didn't have a minor case at all.

So I hope that's kind of encouraging to you that mine can be SO bad and missed. The doctor that finally diagnosed me was my fourth or fifth GYN. I complained about pain from my first doctor on and got told "that's part of being a woman" and other assorted things from awful to simply unhelpful, like the midwife (well woman care, not maternity) who when I told her my periods were super heavy and long, just shook her head and said she didn't like that.. nothing helpful to add or suggest. Keep looking! An excision doc seems so much more likely to just do the surgery, too... and then you get answers. Best of all!

When i was first diagnosed my doctor did not do an ultrasound to look. He listened to what i was saying used his experience and automatically told my mother i needed surgery and it was gonna happen 2 weeks later. He has never once doubted me. He was/is amazing. Had to use another doctor for my 2nd pregnancy and that man did not listen to me about anything. I was very distraught. I'm so sorry you had such a hard time getting the help you needed. Hope you days go well. Hugs