{"paper_id":"200826b7-cdc4-4701-a6eb-7b86a9ce43c5","body_text":"Abstract\nThe pathophysiology of endometriosis-associated pain involves inflammatory and hormonal alterations and changes in brain signaling pathways. Although medical treatment can provide temporary relief, most patients can achieve long-term sustained pain relief when it is combined with surgical intervention. Owing to its complexity, there is an ongoing debate about how to optimally manage endometriosis-associated pain. We believe optimal management for this condition requires (1) possible egg preservation in affected young patients with and without endometriomas, (2) preoperative medical suppression to inhibit ovulation and to avoid removal of functional cysts that might look like endometriomas, and (3) postoperative hormonal suppression to decrease recurrence, but this treatment should be modified according to disease severity, symptoms, and fertility goals.\nFrom the Camran Nezhat Institute, Center for Special Minimally Invasive and Robotic Surgery, Palo Alto, the Stanford University Medical Center, Stanford, and the University of California-San Francisco, School of Medicine, San Francisco, California; and the Nezhat Medical Center, Atlanta, Georgia.\nThe authors thank Drs. Farr Nezhat (Medical Director Nezhat Surgery, Weill Cornell Medical College of Cornell University), Gary Peltz and Lisa Saunders (Department of Anesthesia, Stanford University), and Azadeh Nezhat and Mailinh Vu (Camran Nezhat Institute) for assistance in manuscript preparation.\nEach author has confirmed compliance with the journal’s requirements for authorship.\n© 2019 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.\nISSN: 0029-7844/19.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nGiudice LC, Kao LC. Endometriosis. 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Hum Reprod Update. 2011;17:311–26.\nNezhat F. The link between endometriosis and ovarian cancer: clinical implications. Int J Gynecol Cancer. 2014;24:623–8.\nPeer Review History\nReceived April 16, 2019. Received in revised form June 3, 2019. Accepted June 13, 2019. Peer reviews and author correspondence are available at http://links.lww.com/AOG/B521.\nFinancial Disclosure\nCeana Nezhat disclosed that money has been paid to them by Karl Storz and Lumenis. The other authors did not report any potential conflicts of interest.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2020 Springer Nature Switzerland AG\nAbout this chapter\nCite this chapter\nNezhat, C., Vang, N., Tanaka, P.P., Nezhat, C.H. (2020). Optimal Management of Endometriosis and Pain. In: Nezhat, C.H. (eds) Endometriosis in Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-030-52984-0_7\nDownload citation\nDOI: https://doi.org/10.1007/978-3-030-52984-0_7\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-030-52983-3\nOnline ISBN: 978-3-030-52984-0\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}