GynaecologyFree in the app
Endometriosis
Pain, dysmenorrhoea, dyspareunia, subfertility.
Source: NICE NG73 (2024)Diagnose
- Transvaginal ultrasound for all suspected cases
- Normal scan does not exclude it — consider laparoscopy ± biopsy
- MRI to map deep disease, not as first test
- Do not use CA-125 to diagnose
Treat
- Analgesia (NSAID / paracetamol)
- Hormonal: combined pill or progestogen
- Secondary care: GnRH agonist/antagonist; excision or ablation
- Deep disease (bowel, bladder, ureter): specialist centre
- Trying to conceive: no hormonal suppression
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.