Clinical Diagnosis and Early Medical Management for Endometriosis: Consensus from Asian Expert Group
Issued Date
2022-12-01
Resource Type
eISSN
22279032
Scopus ID
2-s2.0-85144646623
Journal Title
Healthcare (Switzerland)
Volume
10
Issue
12
Rights Holder(s)
SCOPUS
Bibliographic Citation
Healthcare (Switzerland) Vol.10 No.12 (2022)
Suggested Citation
Kim M.R., Chapron C., Römer T., Aguilar A., Chalermchockcharoenkit A., Chatterjee S., Dao L.T.A., Fong Y.F., Hendarto H., Hidayat S.T., Khong S.Y., Ma L., Kumar P., Primariawan R.Y., Siow A., Sophonsritsuk A., Devi Thirunavukarasu R., Thuong B.C., Yen C.F. Clinical Diagnosis and Early Medical Management for Endometriosis: Consensus from Asian Expert Group. Healthcare (Switzerland) Vol.10 No.12 (2022). doi:10.3390/healthcare10122515 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/84764
Title
Clinical Diagnosis and Early Medical Management for Endometriosis: Consensus from Asian Expert Group
Author's Affiliation
Ramathibodi Hospital
Siriraj Hospital
Université Paris Cité
Subang Jaya Medical Centre
Chang Gung University College of Medicine
University of the Philippines College of Medicine
University of Medicine and Pharmacy at HCMC
Hanoi Medical University
Universitas Diponegoro
Universitas Airlangga
National University Hospital
National University of Singapore
Kasturba Medical College, Manipal
Gleneagles Hospital
The Catholic University of Korea, College of Medicine
Academic Hospital of the University
Ramakrishna Medical Centre LLP
Calcutta Fertility Mission
Siriraj Hospital
Université Paris Cité
Subang Jaya Medical Centre
Chang Gung University College of Medicine
University of the Philippines College of Medicine
University of Medicine and Pharmacy at HCMC
Hanoi Medical University
Universitas Diponegoro
Universitas Airlangga
National University Hospital
National University of Singapore
Kasturba Medical College, Manipal
Gleneagles Hospital
The Catholic University of Korea, College of Medicine
Academic Hospital of the University
Ramakrishna Medical Centre LLP
Calcutta Fertility Mission
Other Contributor(s)
Abstract
This work provides consensus guidance regarding clinical diagnosis and early medical management of endometriosis within Asia. Clinicians with expertise in endometriosis critically evaluated available evidence on clinical diagnosis and early medical management and their applicability to current clinical practices. Clinical diagnosis should focus on symptom recognition, which can be presumed to be endometriosis without laparoscopic confirmation. Transvaginal sonography can be appropriate for diagnosing pelvic endometriosis in select patients. For early empiric treatment, management of women with clinical presentation suggestive of endometriosis should be individualized and consider presentation and therapeutic need. Medical treatment is recommended to reduce endometriosis-associated pelvic pain for patients with no immediate pregnancy desires. Hormonal treatment can be considered for pelvic pain with a clinical endometriosis diagnosis; progestins are a first-line management option for early medical treatment, with oral progestin-based therapies generally a better option compared with combined oral contraceptives because of their safety profile. Dienogest can be used long-term if needed and a larger evidence base supports dienogest use compared with gonadotropin-releasing hormone agonists (GnRHa) as first-line medical therapy. GnRHa may be considered for first-line therapy in some specific situations or as short-term therapy before dienogest and non-steroidal anti-inflammatory drugs as add-on therapy for endometriosis-associated pelvic pain.