New ESHRE Guideline and Endometriosis in adolescents

In 2022 ESHRE published their latest Guideline on Endometriosis that offers best practice advice on the care of women with endometriosis, including recommendations on the diagnostic approach and treatments for endometriosis for both relief of painful symptoms and for infertility due to endometriosis.

The guideline provides more than 100 recommendations on best practice on caring for women with endometriosis and is a full revision of the ESHRE guideline on Endometriosis (2014), with major changes in recommendations regarding the relevance of diagnostic laparoscopy and post-operative hormone therapy.

In addition, a new section on endometriosis in adolescence provides information on diagnosis appropriate treatments for symptom management in female adolescents and young adults. The topics of menopause, pregnancy and fertility preservation in relation with endometriosis have been addressed in more detail.

Endometriosis is mainly a disease of women of reproductive age, which is between menarche (the first menstruation during puberty) and menopause. In recent years, endometriosis in adolescents has been recognised as a challenging problem in gynecology.

The diagnostic pathway for endometriosis is similar in adolescents as compared to adults, except some examinations and/or tests may not be appropriate. Based on the efficacy and side-effects, some medical treatments may be more appropriate in adolescents.

First line treatment options in adolescents with endometriosis are hormonal contraceptives or progestogens. If first-line treatment does not resolve the symptoms, NSAIDs or GnRH agonists can be used. Surgery (and post-operative treatment) is also an option in adolescents, but it should be considered that symptoms/disease may recur.

For all involved in the care of women with endometriosis, the latest ESHRE Guideline on Endometriosis is a must read!

The 2022 version of the guideline replaces the previous guideline (Guideline on the management of women with endometriosis 2013/2014) it is available for download on the ESHRE website at https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Endometriosis-guideline