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Feature Article

How to recognise and manage endometriosis

Raewyn Teirney, Ian S Fraser

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Abstract

There is no treatment at present that can absolutely cure endometriosis although it usually cures spontaneously at menopause. Medical or surgical therapy usually relieves symptoms, slows disease progression and can, depending on the therapy chosen, protect fertility.

Key Points

  • Endometriosis is a chronic recurring disease in many women that usually presents as pelvic pain or infertility but may be asymptomatic.
  • The aetiology is unclear, but a genetic component is common.
  • The gold standard for diagnosis is laparoscopy.
  • Medical and surgical treatments need to be individualised, and many women will require both at different times during the course of their disease.
  • A substantial proportion of affected women may gain long term relief following thorough excisional laparoscopic surgery.
  • Endometriosis usually cures spontaneously at menopause, but can occasionally persists during hormone replacement therapy.

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