Letter to the Editor: Clues to revising the conventional diagnostic algorithm for endometriosis

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This letter proposes revisions to the conventional diagnostic algorithm for endometriosis based on new insights and considerations.

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This paper is a letter to the editor proposing revisions to the conventional diagnostic algorithm for endometriosis, commenting on how diagnostic steps could be improved. It draws on prior literature and related diagnostic studies to highlight inconsistencies or limitations within the existing algorithm rather than presenting new original data. A key caveat is that, as a correspondence piece, it does not include systematic new evidence or formal reanalysis of diagnostic accuracy estimates. This paper is centrally about endometriosis — it argues for revising the conventional endometriosis diagnostic algorithm.

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Letter to the Editor: Clues to revising the conventional diagnostic algorithm for endometriosis Corresponding Author François Margueritte UVSQ, INSERM, CESP, Team “Primary Care, Prevention, and Women Healthcare”, Université Paris-Saclay, Villejuif, France Department of Gynaecology and Obstetrics, Women, Mother and Child Hospital, University Hospital Center of Limoges, Limoges, France Correspondence François Margueritte, CESP: Centre de Recherche en Épidémiologie et Santé des Populations, U1018, INSERM, Equipe Primary Care, Prevention, and Women Healthcare, Hôpital Paul Brousse Bat 15/16, 16 Avenue Paul Vaillant Couturier, 94807 Villejuif Cedex, France. Email: [email protected] Search for more papers by this authorArnaud Fauconnier UVSQ, INSERM, CESP, Team “Primary Care, Prevention, and Women Healthcare”, Université Paris-Saclay, Villejuif, France Department of Gynecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France Search for more papers by this authorCorresponding Author François Margueritte UVSQ, INSERM, CESP, Team “Primary Care, Prevention, and Women Healthcare”, Université Paris-Saclay, Villejuif, France Department of Gynaecology and Obstetrics, Women, Mother and Child Hospital, University Hospital Center of Limoges, Limoges, France Correspondence François Margueritte, CESP: Centre de Recherche en Épidémiologie et Santé des Populations, U1018, INSERM, Equipe Primary Care, Prevention, and Women Healthcare, Hôpital Paul Brousse Bat 15/16, 16 Avenue Paul Vaillant Couturier, 94807 Villejuif Cedex, France. Email: [email protected] Search for more papers by this authorArnaud Fauconnier UVSQ, INSERM, CESP, Team “Primary Care, Prevention, and Women Healthcare”, Université Paris-Saclay, Villejuif, France Department of Gynecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France Search for more papers by this authorDATA AVAILABILITY STATEMENT Not applicable. REFERENCES - 1Spiers A, Roman H, Wasson M, et al. Clues to revising the conventional diagnostic algorithm for endometriosis. Int J Gynaecol Obstet. 2025; 168: 101-111. doi:10.1002/ijgo.15840 - 2Nawrocka-Rutkowska J, Szydłowska I, Rył A, Ciećwież S, Ptak M, Starczewski A. Evaluation of the diagnostic accuracy of the interview and physical examination in the diagnosis of endometriosis as the cause of chronic pelvic pain. Int J Environ Res Public Health. 2021; 18:6606. doi:10.3390/ijerph18126606 - 3Fauconnier A, Drioueche H, Huchon C, et al. Early identification of women with endometriosisby means of a simple patient-completed questionnaire screening tool: a diagnostic study. Fertil Steril. 2021; 116: 1580-1589. doi:10.1016/j.fertnstert.2021.07.1205 - 4Rosenbloom BN, Di Renna T, Nella A, et al. Screening for endometriosis: a scoping review of screening measures that could support early diagnosis. BMC Womens Health. 2025; 25: 353. doi:10.1186/s12905-025-03866-1 - 5Nisenblat V, Bossuyt PMM, Farquhar C, Johnson N, Hull ML. Imaging modalities for the non-invasive diagnosis of endometriosis. Cochrane Database Syst Rev. 2016; 2:CD009591. doi:10.1002/14651858.CD009591.pub2 - 6Mackenzie SC, Stephen J, Williams L, et al. Effectiveness of laparoscopic removal of isolated superficial peritoneal endometriosis for the management of chronic pelvic pain in women (ESPriT2): protocol for a multi-centre randomised controlled trial. Trials. 2023; 24: 425. doi:10.1186/s13063-023-07386-x - 7Bendifallah S, Roman H, Suisse S, et al. Validation of a saliva micro–RNA signature for endometriosis. NEJM Evid. 2025; 4:EVIDoa2400195. doi:10.1056/EVIDoa2400195 - 8Le Moal J, Goria S, Chesneau J, et al. Increasing incidence and spatial hotspots of hospitalized endometriosis in France from 2011 to 2017. Sci Rep. 2022; 12: 6966. doi:10.1038/s41598-022-11017-x - 9Margueritte F, Fauconnier A. Adolescent endometriosis: should we really use magnetic resonance imaging scans in this population? Fertil Steril. 2023; 120: 706. doi:10.1016/j.fertnstert.2023.05.155 - 10Vercellini P, Bandini V, Viganò P, Ambruoso D, Cetera GE, Somigliana E. Proposal for targeted, neo-evolutionary-oriented secondary prevention of early-onset endometriosis and adenomyosis. Part II: medical interventions. Hum Reprod. 2023; 39:dead206. doi:10.1093/humrep/dead206 Article Metrics Total unique accesses to an article’s full text in HTML or PDF/ePDF format.More metric information Scite metrics Explore this article's citation statements on scite.ai Share QR Code Generating QR code QR code copied to clipboard! Something went wrong while generating your QR code. Please try again in a moment. If the issue persists, refresh the page or contact support. Export citation Unable to load citation data. Please try again in a moment. How to cite Elkins, L. J., & Spiegelman, M. (2021). pyUserCalc: A revised Jupyter notebook calculator for uranium-series disequilibria in basalts. Earth and Space Science, 8, e2020EA001619. https://doi.org/10.1029/2020EA001619 Download Citation If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click on download. 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