American College of Obstetricians and Gynecologists (ACOG): Obstetrics and Gynecology Journal

TAKE HOME MESSAGE:

Endometriosis is a common and challenging condition of reproductive-aged women that carries a high individual and societal cost. Endometriosis is associated with chronic pain, subfertility, and a mildly increased risk of ovarian cancer.

The much molecular dissimilarity between endometriosis lesions and eutopic endometrium create difficulties in the development of new drug therapies and treatments.

Surgery remains the gold standard for definitive diagnosis, but it must be weighed against the risks of surgical morbidity and potential decreases in ovarian reserve, especially in the case of endometriomas.

Medical therapy is suppressive rather than curative, and regimens that are long-term and affordable with minimal side effects are recommended.

Recurrences are common and often rapid when medical therapy is discontinued.

In patients with chronic pain, central sensitization and myofascial pain are integral components of a multidisciplinary approach.

Endometriosis is associated with an increased risk of epithelial ovarian cancer; however, the risk is low and currently no preventive screening is recommended.

Hormone therapy for symptomatic women with postsurgical menopause should not be delayed as a result of concerns for malignancy or recurrence of endometriosis.