Summary

• Chronic inflammatory condition defined by endometrial stroma and glands found outside of the uterine cavity. The most common sites affected are the pelvic peritoneum and ovaries.
• May present incidentally in asymptomatic patients, or more commonly in women of reproductive age who complain of chronic pelvic pain and/or sub-fertility.
• Clinical suspicion is generally sufficient to initiate therapy, but the diagnosis can only be confirmed by direct visualisation and focused biopsies during laparoscopy.
• Treatment options include NSAIDs, combined oral contraceptive pills, GnRH agonists, progestin-containing compounds, danazol (or related androgens), and surgical destruction of lesions. Controlled ovarian hyper-stimulation and IVF may be considered for patients with sub-fertility.
• Individualised care for patients with pelvic pain should incorporate a multi-disciplinary evaluation and treatment plan that focuses on limiting the risk of recurrence and improving quality of life.