According to the Practice Committee of the American Society for Reproductive Medicine, “endometriosis should be viewed as a chronic disease that requires a life-long management plan with the goal of maximizing the use of medical treatment and avoiding repeated surgical procedures” . Despite extensive research, the optimal management of endometriosis is unclear. This topic will review medical and surgical options for treating women with this disease. Clinical features and diagnosis of endometriosis, as well as management of thoracic endometriosis, are discussed separately. (See "Pathogenesis, clinical features, and diagnosis of endometriosis" and "Thoracic endometriosis".)
Clinical manifestations of endometriosis fall into three general categories: pelvic pain, infertility, and pelvic mass. The goal of therapy is to relieve these symptoms. There is no high quality evidence that one medical therapy is superior to another for managing pelvic pain due to endometriosis, or that any type of medical treatment will affect future fertility. Therefore, treatment decisions are individualized, taking into account the severity of symptoms, the extent and location of disease, whether there is a desire for pregnancy, the age of the patient, medication side effects, surgical complication rates, and cost.
Treatment options include: