Guideline No. 468: Clinical Management of Endometriosis

OBJECTIVE: To provide health care professionals with an evidence-based approach to the management of endometriosis and its associated symptoms. TARGET POPULATION: Women and gender-diverse individuals affected by endometriosis. BENEFITS, HARMS, AND COSTS: Timely and effective management of endometriosis has the potential to reduce pain, improve fertility and quality of life, and enhance long-term health outcomes. Early intervention may also help mitigate the financial and health system burdens associated with delayed diagnosis and treatment. EVIDENCE: Published literature was retrieved through searches of PubMed, Ovid, Medline, Embase, Scopus, and the Cochrane Library from August 2010 through December 2025, using relevant MeSH heading and keywords. Results were restricted to systematic reviews, meta-analyses, randomized controlled trials/controlled clinical trials, observational studies, and clinical practice guidelines. Results were limited to English or French language materials. Evidence was supplemented with references from the 2010 Society of Obstetricians and Gynaecologists of Canada guideline No. 244. VALIDATION METHODS: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional recommendations). INTENDED AUDIENCE: Health care providers involved in the care of individuals with endometriosis. SOCIAL MEDIA ABSTRACT: Early identification and management of endometriosis can significantly improve patient outcomes, reduce long-term health care costs and improve their quality of life. SUMMARY STATEMENTS: RECOMMENDATIONS.