![]() Real world data on symptomology and diagnostic approaches of 27,840 women living with endometriosis. Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control study-Part 1. What's the delay? A qualitative study of women's experiences of reaching a diagnosis of endometriosis. ![]() Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Evaluation and treatment of endometriosis. Saha R, Pettersson HJ, Svedberg P, et al. Rahmioglu N, Montgomery GW, Zondervan KT. ![]() Clinical characteristics of familial endometriosis. Optimal management of endometriosis and pain. The expression and cellular localisation of neurotrophin and neural guidance molecules in peritoneal ectopic lesions. Treatment of endometriosis-associated pain with elagolix, an oral GnRH antagonist. Pathogenesis and pathophysiology of endometriosis. Real-world evaluation of direct and indirect economic burden among endometriosis patients in the United States. Endometriosis: ancient disease, ancient treatments. Risk for and consequences of endometriosis: a critical epidemiologic review. Alternative treatments have limited benefit in alleviating pain symptoms but may warrant further investigation. ![]() Referral to gynecology for surgical management is indicated if empiric therapy is ineffective, immediate diagnosis and treatment are necessary, or patients desire pregnancy. All of these treatments are effective but may cause additional adverse effects. Aromatase inhibitors are reserved for severe disease. Second-line treatments include gonadotropin-releasing hormone (GnRH) receptor agonists with add-back therapy, GnRH receptor antagonists, and danazol. Combined hormonal contraceptives with or without nonsteroidal anti-inflammatory drugs are first-line options in managing symptoms and have a tolerable adverse effect profile. Laparoscopy with biopsy remains the definitive method for diagnosis, although several gynecologic organizations recommend empiric therapy without immediate surgical diagnosis. Although transvaginal ultrasonography is used to evaluate endometriosis of deep pelvic sites to rule out other causes of pelvic pain, magnetic resonance imaging is preferred if deep infiltrating endometriosis is suspected. Diagnosis of endometriosis in the primary care setting is clinical and often challenging, frequently resulting in delayed diagnosis and treatment. Presentation of endometriosis can vary widely, from infertility in asymptomatic people to debilitating pelvic pain, dysmenorrhea, and period-related gastrointestinal or urinary symptoms. It is one of the most common gynecologic disorders, affecting up to 10% of people of reproductive age. Endometriosis is an inflammatory condition caused by the presence of endometrial tissue in extra-uterine locations and can involve bowel, bladder, and all peritoneal structures.
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