Medical management of endometriosis

Abstract

Endometriosis is increasingly being recognised as a disease which commonly affects women through the reproductive years. It is the commonest cause of chronic pelvic pain in developed countries, and frequently begins in adolescence. Endometriosis is a highly variable condition, and diagnosis can be difficult. Confirmation of diagnosis still requires laparoscopy in most situations, but successful therapy of many, especially milder, cases can be based on a presumptive diagnosis. A careful history needs to be taken to try and exclude other common causes of pelvic pain. Medical management requires treatment of pain with analgesics, and suppression of disease activity mainly with hormonal preparations. This needs to be integrated with the potential need for surgery. Patients with persistent pain unresponsive to hormonal treatments and analgesics should be referred for specialist care.