gynecology and obstetrics
Endometriosis
Key Points
Endometriosis is a common cause of cyclic and chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. The stage of endometriosis does not correlate with severity of symptoms. Confirm the diagnosis usually by laparoscopy; a biopsy is not mandatory but may aid in the diagnosis. Treat pain (eg, with NSAIDs) and, depending on patient fertility goals, usually use drugs that suppress ovarian function to inhibit the growth and activity of endometriotic implants. For moderate to severe endometriosis, consider ablating or excising as many implants as possible while restoring normal pelvic anatomy. Reserve hysterectomy for women who have completed childbearing or who prefer a definitive procedure. 