Endometriosis: Current Trends in Management

This open-access narrative review describes current diagnostic and management trends for endometriosis, a common cause of chronic pelvic pain and infertility, outlining symptom patterns, major anatomic sites, and diagnostic approaches including clinical suspicion, transvaginal ultrasound, and MRI for more advanced/deep disease. It reports that laparoscopy is considered the gold standard for diagnosis and treatment but notes key limitations: visual inspection is not confirmatory, negative biopsy does not rule out endometriosis, deep infiltrating lesions may be missed, and CA-125 has controversial diagnostic value and a normal level does not exclude disease. The review summarizes medical therapies aimed at reducing inflammation and suppressing estrogen (e.g., NSAIDs, combined oral contraceptives, progestins including dienogest, GnRH agonists with add-back therapy, GnRH antagonists, aromatase inhibitors, and SPRMs) and surgical options such as excision/ablation, adhesiolysis, and cystectomy. This paper is centrally about endometriosis — it is a review of current trends in diagnosis and management.

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