The aim of this guideline is to provide clinicians with up-to-date information about the diagnosis and treatment of endometriosis, based upon the best available evidence. The treatment options are examined in the light of presenting symptoms and associated infertility.
Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induces a chronic, inflammatory reaction. The condition is predominantly found in women of reproductive age, from all ethnic and social groups.The associated symptoms can impact on general physical, mental and social wellbeing. It is therefore vital to take careful note of the woman’s complaints and to give her time to express her concerns and anxieties, as with other chronic diseases. However, women may have no symptoms at all. Finding endometriosis in some women, therefore, may be coincidental. Treatment must be individualised, taking the clinical problem in its entirety into account, including the impact of the disease and the effect of its treatment on quality of life. Pain symptoms may persist despite seemingly adequate medical and/or surgical treatment of the disease. This may suggest another source of pain, such as the uterus (adenomyosis), bladder (interstitial cystitis) or musculoskeletal causes (pelvic floor muscle spasm). In such circumstances, the appropriate therapy or a multidisciplinary approach involving a pain clinic and counselling should be considered. It is also important to involve the woman in all decisions, to be flexible in diagnostic and therapeutic thinking, to maintain a good relationship with the woman and to seek advice where appropriate from more experienced colleagues.
This guideline can be downloaded as a pdf by clicking the link below.
A Russian language translation of this guideline is also available:
