diagnosis and management

Slideshow: Endometriosis Guidelines

  • Endometriosis is a common condition that affects approximately 10% of women of reproductive age. This slideshow features the American Family Physician's key recommendations for clinical practice on the diagnosis, treatment, and management of endometriosis. 

  • After examining the patient's history and physical examination findings, the next step in the diagnostic process for patients with suspected endometriosis is to confirm the diagnosis with histologic testing. The guidelines encourage physicians to use less-invasive techniques where possible, such as a transvaginal ultrasonography instead of a laparoscopy. 

  • Many patients with endometriosis experience pain. The guidelines recommend the use of ovulation suppression therapies, such as oral contraceptives or gonadotropin-releasing hormone analogues, to reduce these symptoms. Also among the evidence-based treatments for endometriosis-related pain are nonsteroidal anti-inflammatory drugs (NSAIDs), medroxyprogesterone, levonorgestrel-releasing intrauterine systems, and danazol. 

  • Fertility issues can occur in up to half of all patients with endometriosis. Laparoscopic ablation of deposits, excision of endometriomas, and surgical removal of ectopic endometrial issue are among the surgical treatment options available to mitigate endometriosis-related fertility. 

  • While ovulation suppression therapies may be effective at treating pain in patients with endometriosis, these treatments are not effective for managing fertility. To improve pregnancy rates, practitioners should prioritize surgical treatment options.

  • To learn more about endometriosis, visit our Resource Center.



    Schrager S, Falleronni J, Edgoose J. Evaluation and treatment of endometriosis. Am Fam Physician. 2013; 87(2):107-113.