Evaluation and management of endometriosis

Tevfik Yoldemir
Climacteric : the journal of the International Menopause Society · 2023 · vol. 26(3) , pp. 248–255 · doi:10.1080/13697137.2023.2190882 · PMID:37051875 · W4365443441
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

Physical examination and pelvic ultrasound are initial diagnostic tools for endometriosis, with MRI recommended for assessing extent and guiding surgical needs, while management focuses on functional impact and quality of life.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-06 · read from full text ⓘ

This 2023 paper reviews the evaluation and management of endometriosis, outlining initial diagnostic investigations using physical examination (including speculum exam and vaginal palpation) and pelvic ultrasound, with assessment of uterine mobility/fixation/tenderness and site-specific pelvic tenderness. It recommends transvaginal ultrasound and pelvic MRI to evaluate disease extent and to determine whether urinary tract or bowel procedures may be needed during surgical resection, while also recommending quality-of-life assessment using EHP-30/EHP-5 or SF-36. The paper states that management is recommended when endometriosis has functional impact such as pain or infertility or causes organ dysfunction, and notes that multiple society guidelines exist with discrepancies due to disease complexity and treatment options. It includes risk considerations such as malignant transformation estimated at about 0.7–1.6% and an association with increased ovarian cancer risk, and it addresses postmenopausal endometriosis. This paper is centrally about endometriosis — it focuses on how endometriosis is evaluated and managed, including diagnostic workup, quality-of-life assessment, and treatment guideline discrepancies.

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Abstract

The initial diagnostic investigations for endometriosis are physical examination and pelvic ultrasound. The pelvic examination should include a speculum examination and vaginal palpation. Mobility, fixation and/or tenderness of the uterus and site-specific tenderness in the pelvis should be evaluated. Transvaginal ultrasound and pelvic magnetic resonance imaging are recommended to evaluate the extent of the endometriosis and to determine whether any urinary tract or bowel procedures might also be required during surgical resection. Quality of life should be assessed by using the Endometriosis Health Profile-30, its short version EHP-5 or the generic quality of life questionnaire SF-36. Management of endometriosis is recommended when it has a functional impact (pain, infertility) or causes organ dysfunction. Many gynecological societies have published different guidelines for the evaluation and management of endometriosis. However, the complexity of this disease together with the different available treatments lead to significant discrepancies between the recommendations. Postmenopausal endometriosis should be considered when a patient has a history of symptoms before menopause including dysmenorrhea, dyspareunia, dyschezia, infertility and chronic pelvic pain. Malignant transformation of endometriosis is estimated to occur in about 0.7-1.6% of women affected by endometriosis. Endometriosis is associated with an increased risk of ovarian cancer, specifically clear cell, endometrioid and low-grade serous types.
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Publication: Evaluation and management of endometriosis. Loading... Files Date Authors Journal Title Journal ISSN Volume Title Publisher Abstract The initial diagnostic investigations for endometriosis are physical examination and pelvic ultrasound. The pelvic examination should include a speculum examination and vaginal palpation. Mobility, fixation and/or tenderness of the uterus and site-specific tenderness in the pelvis should be evaluated. Transvaginal ultrasound and pelvic magnetic resonance imaging are recommended to evaluate the extent of the endometriosis and to determine whether any urinary tract or bowel procedures might also be required during surgical resection. Quality of life should be assessed by using the Endometriosis Health Profile-30, its short version EHP-5 or the generic quality of life questionnaire SF- 36. Management of endometriosis is recommended when it has a functional impact (pain, infertility) or causes organ dysfunction. Many gynecological societies have published different guidelines for the evaluation and management of endometriosis. However, the complexity of this disease together with the different available treatments lead to significant discrepancies between the recommendations. Postmenopausal endometriosis should be considered when a patient has a history of symptoms before menopause including dysmenorrhea, dyspareunia, dyschezia, infertility and chronic pelvic pain. Malignant transformation of endometriosis is estimated to occur in about 0.7–1.6% of women affected by endometriosis. Endometriosis is associated with an increased risk of ovarian cancer, specifically clear cell, endometrioid and low-grade serous types. Description Citation Yoldemir T., "Evaluation and management of endometriosis.", Climacteric : the journal of the International Menopause Society, ss.1-8, 2023

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Outcome instruments

EHP-30

Condition tags

dysmenorrheadyspareuniaendometriosischronic_pelvic_paininfertility

MeSH descriptors

Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia

Citation neighborhood

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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