Can an HSG detect endometriosis?

An HSG (hysterosalpingogram) is designed to evaluate the uterine cavity and whether the fallopian tubes are open, so it does not reliably detect endometriosis. Most endometriosis lesions are on the outside surfaces of pelvic organs or deeper within tissues, areas an HSG can’t visualize.

That said, an HSG can sometimes hint at problems that can coexist with endometriosis or be related to it, like tubal blockage, scarring, or distorted tubal anatomy. These findings matter, especially when fertility is part of the concern. In our evaluation, we look at your full symptom pattern and history, then use targeted tools like expertly interpreted ultrasound or MRI when appropriate. We reserve surgery and tissue confirmation for situations where it will truly change management.

If you’ve had an HSG and still feel you don’t have clear answers, we can help you connect the dots. Endometriosis is often missed when testing is limited to what’s easiest to measure. Reach out to schedule a consultation so our team can review your symptoms and prior imaging and map out the most direct path to an accurate diagnosis and durable relief.