As previous showed, there is only a 7% agreement between the widely used guidelines and none of them is following the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) protocol. The variety of the available treatments in combination with complexity of this illness leads to significant discrepancies between the recommendations. Many gynecological societies have published different guidelines in order to help the clinicians with the diagnosis and treatment of endometriosis. The importance of endometriosis as a major health issue with socioeconomical impact is underlined by the EndoCost study, which showed that costs arising from endometriosis are comparable to that of other chronic diseases, such as diabetes mellitus. The wide range of symptoms, such as chronic pelvic pain, dysmenorrhea, infertility, dyspareunia, dysuria, dyschezia and fatigue which characterize this estrogen-dependent condition, result to a delayed diagnosis.
It mainly affects women of reproductive age, with a prevalence of about 10%. Discrepancies are also found on recommendation of the second- and third-line treatments.Įndometriosis is an inflammatory entity with the presence of endometrial-like tissue outside the uterine cavity. Concerning infertility, there is no clear consensus about surgical treatment. ConclusionĪll the above-mentioned guidelines agree that the combined oral contraceptive pill, progestogens are therapies recommended for endometriosis associated pain. Six national (College National des Gynecologues et Obstetriciens Francais, National German Guideline (S2k), Society of Obstetricians and Gynaecologists of Canada, American College of Obstetricians (ACOG) and Gynecologists, American Society for Reproductive Medicine (ASRM) and National Institute for Health and Care (NICE) and two international (World Endometriosis Society, European Society of Human Reproduction and Embryology) guidelines are included in this review. The aim of this review is to give an overview on therapeutical approaches of eight national and international widely used guidelines. Due to the variety of endometriosis-associated symptoms, a great variety of treatments have been implemented.
Endometriosis, the presence of endometrial-like tissue outside the uterus, is a common clinical entity between women of reproductive age, with a prevalence of about 10%.
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