Treatment of moderate-severe pain associated with early stage endometriosis; a consensus panel summary

Abstract

Few chronic diseases carry such a personal and societal burden as endometriosis. Amultitude of symptoms similar to other diseases and various contributors to the diseasecompounds its complexity and perpetuates the delay in diagnosis and treatment. Thisliterature review and consensus panel synthesized the current research and clinicalpractices to develop a clinical algorithm to reduce symptoms, minimize time to diagnosis,and improve patient quality of life outcomes. Evaluating patients at earlier stagedendometriosis using best clinical practice should speed diagnosis but also intervene inthe disease process to better manage the chronicity. Treatment of the disease andsymptoms by modulating estradiol levels through medical therapy provides noninvasivepain relief. Initial evaluation with detailed patient history, examination, and utilizing paindiaries determine the course of action. The use of intentional medical therapy andscheduled follow-up provides structure for future clinical decisions to be based on. Shareddecision making between clinician and patient is important to ensure patient goals andbest clinical options are utilized. Surgical intervention should be used strategically andcombined with medical therapy to provide morepredictable patient outcomes with longerlasting results than surgery alone.