Centre for Reproductive Health

New guidelines launched for diagnosis and management of Endometriosis

The European Society of Human Reproduction and Embryology (ESHRE) publishes today its new clinical guidelines for the diagnosis, treatment and management of Endometriosis - a chronic condition that causes severe pelvic pain and reduced fertility for millions of women worldwide. 

The original guidelines to help clinicians to apply best care for Endometriosis were first produced in 2008 and then updated in 2014 with a patient led version. This new 3rd, entirely updated version of the guidelines also expands on important issues such as the clinical evidence on Endometriosis in adolescents and postmenopausal women. It outlines the diagnostic process, challenges laparoscopy and histology as the overall gold standard diagnostic tests, and it evaluates surgical, medical and non-pharmacological treatments.

Over two years, the chair of the Guideline Development Group Prof Christian Becker from the Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, at the University of Oxford and Dr Nathalie Vermeulen, Senior Research Specialist at ESHRE, who led the search strategy, worked closely together with international medical and epidemiological experts in the field as well as patient representatives.                                           

This wide-ranging collaboration helped create the comprehensive new ESHRE Guidelines which include 109 recommendations on diagnosis, treatments for pain and infertility, management of disease recurrence, asymptomatic or extrapelvic disease, endometriosis in adolescents and postmenopausal women, prevention and the association with cancer. 

The impact of these new guidelines on the general physical, mental and social well-being of the Endometriosis community could be huge.

Prof Christian Becker commented: “Endometriosis is a very common, but still highly underrepresented disease with often devastating outcomes for the patients and their families. Together with my colleagues we hope that the new ESHRE Endometriosis Guideline will assist both patients and healthcare professionals in their decision making and understanding of the condition.”

Kathleen King, endometriosis advocate (Ireland) and patient representative in the Guideline Development Group stated “I welcome the publication of the current ESHRE Endometriosis guidelines; the collaborative process involving patient representatives and medical professionals has produced a document that will become an essential part of the toolkit for those living with endometriosis symptoms. Patients can feel confident in using the guidelines to open discussions  with their healthcare professionals and in turn their healthcare team have a guide based on current best practice and scientific information. I encourage all those with an interest in endometriosis to make full use of the guidelines."

Professor Andrew Horne
Professor Andrew Horne

Dr Nathalie Vermeulen, revealed the possible benefits to patients: “While for some topics, new studies could be integrated in new or improved recommendations for clinical practice, there are still a lot of unknowns. Apart from guiding clinical practice, this guideline also highlights research gaps to be considered by clinicians, researchers and funding agencies”

Professor Andrew Horne, Professor of Gynaecology and Reproductive Sciences at MRC Centre for Reproductive Health, who was member of the Core Guideline Development Group, said: “It was a pleasure to be involved in updating the European ESHRE guideline for endometriosis which, I think, will be incredibly useful for doctors and for patients. It will help direct clinicians how to diagnose and manage endometriosis in a more effective and evidence-based manner.”

The full guidelines can be found here https://www.eshre.eu/Guideline/Endometriosis