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Medical and surgical management of endometriosis 

Medical and surgical management of endometriosis
Chapter:
Medical and surgical management of endometriosis
Author(s):

Enda McVeigh

, John Guillebaud

, and Roy Homburg

DOI:
10.1093/med/9780199650682.003.0017
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date: 05 May 2021

Introduction

Examination and investigations

Endometriosis-associated infertility

Surgical treatment of endometriosis

NICE guidelines

Medical treatment

Oral contraceptive pill (OCP)

Progestins

Gonadatrophin-releasing hormone agonists

Danazol

Aromatase inhibitors

Comparison of different medical treatments for endometriosis

Further reading and information

Endometriosis is characterized by the presence of endometrial tissue (glandular and stromal tissue) in areas outside the uterus. It has been considered for decades as the result of the implantation of retrograde menstruated endometrial cells (Sampson’s theory), or as metaplasia induced by menstrual debris, or as lymphatic spread. It occurs most frequently in the pelvic organs and peritoneum and is prevalent in 2.5–3.3% of women of reproductive age. Endometriosis is a surgical diagnosis. In a hospital-based population, however, the prevalence of endometriosis will vary depending on the type of the population being studied, e.g. it is seen more frequently among women being investigated for infertility (21%) than among those undergoing sterilization (6%). The incidence of endometriosis among those women being investigated for chronic abdominal pain is 15%, while among those undergoing abdominal hysterectomy, it can be as high as 25%....

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