What could be the problem

My periods are so severe since I was 14 and I experience clotting during my period and my ultra sound is clear and I constipate and bloat a lot and sometimes the periods are heavy and lasts for 7 days.
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Antonio Gargiulo MD

This case needs to be evaluated thoroughly through a consultation with an endometriosis expert. Qualitative and quantitative changes overtime, as well as the appearance of associated symptoms beyond the muscle cramping are highly suggestive of endo. All pelvic ultrasound will always miss deep infiltrating endometriosis. Expert endometriosis, ultrasound will almost never miss the infiltrating endometriosis. This said, even under the best of hands the chance that stage one or two (minimal or mild) endometriosis are in fact, detected is quite low, well below 50%. Therefore a good number of patients will be offered surgical exploration and radical excision in single session, even with normal ultrasound. Obviously response or lack there of to protesting treatment is also an important factor both in diagnosis and in surgical planning.

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