Controversies in the Management of Endometrioma: To Cure Sometimes, to Treat Often, to Comfort Always?

Erica B Johnstone, Erica Johnstone, Johnstone EB, Link MH, Megan H Link, M. Link
Clinical Obstetrics and Gynecology · 2015 · vol. 58(4) , pp. 754–764 · doi:10.1097/grf.0000000000000151 · PMID:26512440 · W2409376002
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

Surgical excision improves pelvic pain and may boost spontaneous pregnancy chances, whereas medical treatments primarily address dysmenorrhea, with individualized management considering fertility goals.

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Abstract

Endometriomas are common in reproductive-aged women, but controversy exists regarding their management. PubMed was searched to identify pertinent studies on outcomes of medical and surgical management of endometrioma, with focus on randomized controlled trials and meta-analyses. Surgical excision is more effective than fenestration/coagulation of endometrioma for pelvic pain but decreases antimullerian hormone. It may modestly improve the chances of spontaneous pregnancy, but does not impact chances of success with in vitro fertilization. Oral contraceptive pills improve dysmenorrhea but not dyspareunia or noncyclic pelvic pain. Management of the patient with endometrioma should be individualized based on each patient's particular symptoms and short-term and long-term fertility goals.

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Condition tags

dysmenorrheadyspareuniaendometriosischronic_pelvic_painendometrioma

MeSH descriptors

Contraceptives, Oral Endometriosis Endometriosis Ovarian Diseases Ovarian Diseases Contraceptives, Oral Contraceptives, Oral Dysmenorrhea Dysmenorrhea Dysmenorrhea Dyspareunia Dyspareunia Dyspareunia Endometriosis Endometriosis Endometriosis Female Female Fertility Fertility

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (62)

Cited by (6)

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