A New Guideline on Endometriosis

I regularly discuss it on my Instagram; I have Grade 4 Endometriosis, which has been causing severe abdominal pain and infertility for years, starting when I was 14.

Now, researchers have compiled a set of guidelines for healthcare practitioners following a period during which the condition went largely unnoticed. 

Endometriosis can be profoundly debilitating and distressing. Menstrual periods can escalate to excruciating pain levels, leading to nausea and fainting among those affected. Shockingly, it typically takes a staggering eight years, on average, for a diagnosis, although one in ten women suffer from this condition.

This ailment arises when tissue resembling the lining of the uterus starts growing in places outside the womb, such as the fallopian tubes and ovaries. Every month, this tissue bleeds like a regular period, but the blood cannot exit the body, resulting in inflammation. In some instances, cysts develop on the ovaries, and organs can adhere to each other.

Despite the seriousness of the condition, a 2018 report on women’s health by APG revealed that 40% of women had to visit a doctor up to 10 times before being referred to a gynecologist. Furthermore, 42% felt they did not receive ‘dignity and respect’ from doctors.

Fortunately, there is hope for improved treatment and support for women with endometriosis thanks to new guidelines developed by scientists at a UK-based college and hospitals. Experts have met this development in medical care with enthusiasm.


Professor Ertan Saridogan, working with the Guideline Development Group since 2003, commented on the project and stated, “This new initiative addresses crucial aspects, including the clinical evidence related to endometriosis in adolescents and postmenopausal women. It also outlines the diagnostic process, challenges the current use of laparoscopy and histology as the primary diagnostic tests, and evaluates surgical, medical, and non-pharmacological treatments.”

The new guidelines include over 100 diagnostic recommendations, expanding beyond the current clinical examination for women suspected of having endometriosis. Additionally, the policies will provide additional guidance for women experiencing pain and fertility issues associated with the disease.

The recommendations have been revised to include guidance for postmenopausal and adolescent patients. Clinicians are now advised to consider symptoms such as pelvic pain, nausea, severe cramps, emotional distress, painful urination, and discomfort during intercourse as indicators of the condition. Additionally, there have been advancements in the recommendation guidelines for preventing endometriosis and incorporating it into cancer-related testing and treatment protocols.

These comprehensive guidelines are desperately needed after enduring years of medical bias and patient suffering. A troubling 2019 BBC investigation revealed that half of individuals with endometriosis have contemplated suicide due to the condition’s impact.

Professor Christian Becker, the chair of the Guideline Development Group, emphasized, “Endometriosis is a highly prevalent yet significantly underrepresented disease that often leads to devastating consequences for patients and their families. Alongside my colleagues, we hope the new ESHRE Endometriosis Guideline will provide valuable support to patients and healthcare professionals, aiding them in decision-making and enhancing their understanding of this condition.”

Source: University College London and University College London Hospitals

What is endometriosis?

Endometriosis is a medical condition in which tissue similar to the lining of the uterus (endometrium) grows outside the uterus. This tissue can be found on the ovaries, fallopian tubes, the outer surface of the uterus, and other pelvic organs.

What causes endometriosis?

The exact cause of endometriosis is not fully understood. Still, several theories suggest it may result from genetic factors, hormonal imbalances, or retrograde menstruation, where menstrual blood flows backward into the pelvis instead of out of the body.

What are the common symptoms of endometriosis?

Common symptoms of endometriosis include pelvic pain, severe menstrual cramps, pain during intercourse, heavy menstrual bleeding, and sometimes, infertility. Some individuals with endometriosis may also experience gastrointestinal or urinary symptoms.

How is endometriosis diagnosed?

The diagnosis of endometriosis typically involves a combination of a medical history review, pelvic examination, imaging tests (like ultrasound), and often a laparoscopy, a minimally invasive surgical procedure, to visualize and confirm the presence of endometrial tissue outside the uterus.

What treatment options are available for endometriosis?

Treatment for endometriosis depends on the severity of symptoms and a person’s desire for fertility. Standard treatment options include pain medications, hormonal therapy (such as birth control pills), surgery to remove endometrial tissue (laparoscopic excision), and, in some cases, assisted reproductive technologies (ART) for individuals struggling with infertility due to endometriosis. Treatment choice is highly individualized and should be discussed with a healthcare provider.

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