Presentation of symptoms with endometriosis is variable. I was always taught that someone with the most severe endometriosis can be asymptomatic and someone with the tiniest amount can have severe pain. The most common symptom is pelvic pain, especially with periods.
patients have not had any imaging to show they even have a current cyst. Or they have been seen in the emergency department recently and were told that a cyst could be causing their pain. As you can imagine, the answer is not always so clear. Why is that? Because it is natural for women of reproductive age to make cysts each month! So the emergency room provider, if they do not find anything emergent, will often tell you it could be the little cyst causing your pain.