Consensus on current management of endometriosis

TLDR

Endometriosis management worldwide relies partly on evidence‑based practices and partly on unsubstantiated therapies, and existing guidelines leave controversies due to limited firm evidence. The study aimed to generate an international consensus statement on endometriosis management that incorporates women’s perspectives by convening a global consortium of 34 organizations. A rigorous pre‑ and post‑meeting process engaged 56 representatives from 34 national and international medical and non‑medical societies, producing 69 consensus statements. The consensus produced 69 statements, of which seven achieved unanimous agreement, only two failed to reach majority consensus, and all statements included caveats regarding their strength, covering global considerations, organizational roles, and comprehensive treatment options.

Abstract

Is there a global consensus on the management of endometriosis that considers the views of women with endometriosis?It was possible to produce an international consensus statement on the current management of endometriosis through engagement of representatives of national and international, medical and non-medical societies with an interest in endometriosis.Management of endometriosis anywhere in the world has been based partially on evidence-based practices and partially on unsubstantiated therapies and approaches. Several guidelines have been developed by a number of national and international bodies, yet areas of controversy and uncertainty remain, not least due to a paucity of firm evidence.A consensus meeting, in conjunction with a pre- and post-meeting process, was undertaken.A consensus meeting was held on 8 September 2011, in conjunction with the 11th World Congress on Endometriosis in Montpellier, France. A rigorous pre- and post-meeting process, involving 56 representatives of 34 national and international, medical and non-medical organizations from a range of disciplines, led to this consensus statement.A total of 69 consensus statements were developed. Seven statements had unanimous consensus; however, none of the statements were made without expression of a caveat about the strength of the statement or the statement itself. Only two statements failed to achieve majority consensus. The statements covered global considerations, the role of endometriosis organizations, support groups, centres or networks of expertise, the impact of endometriosis throughout a woman's life course, and a full range of treatment options for pain, infertility and other symptoms related to endometriosis.This consensus process differed from that of formal guideline development. A different group of international experts from those participating in this process would likely have yielded subtly different consensus statements.This is the first time that a large, global, consortium, representing 34 major stake-holding organizations from five continents, has convened to systematically evaluate the best available current evidence on the management of endometriosis, and to reach consensus. In addition to 18 international medical organizations, representatives from 16 national endometriosis organizations were involved, including lay support groups, thus generating input from women who suffer from endometriosis.