Evaluation and Management of Women With Endometriosis

Craig A. Winkel
In: Obstetrics & Gynecology · 2003 · vol. 102(2) , pp. 397–408 · doi:10.1097/00006250-200308000-00032 · W4232043501
article OA: closed CC0 ⤵ 47 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Diagnosis of endometriosis can be made reliably through clinical evaluation, and management should prioritize first- and second-line medical therapies over surgery unless medically contraindicated or the patient desires immediate conception.

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Abstract

In Brief Endometriosis is a condition that often leads to a variety of symptoms that range from pain complaints to infertility. Endometriosis is also found in women who are asymptomatic. The diagnosis of endometriosis can be made clinically with reliability similar to that of one made surgically. Medical treatment options are effective, as are surgical treatment options. Complications associated with surgery, however, push the balance in favor of medical therapy whenever possible. Based on the body of evidence available at present, women with endometriosis-related complaints should be treated with a first-line medical therapy. If that fails, a second-line medical therapy is warranted under most conditions. Laparoscopic surgery should be reserved for patients in whom second-line medical therapy has failed or is contraindicated by desire to conceive immediately or as soon as possible. The diagnosis of endometriosis can be made most of the time asaccurately by clinical evaluation as by surgical intervention, and management, in most cases, should commence with medical rather than surgical therapy.

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Condition tags

endometriosisinfertility

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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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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