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J Minim Invasive Gynecol. 2020 Feb;27(2):270-279. doi: 10.1016/j.jmig.2019.10.012. Epub 2019 Oct 24.

A Practical Guide to the Clinical Evaluation of Endometriosis-Associated Pelvic Pain.

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Department of Obstetrics and Gynecology, Atrium Health, Charlotte, North Carolina (Dr. Vilasagar).
Department of Obstetrics and Gynaecology, Queen's University, Kingston (Dr. Bougie).
Department of Obstetrics and Gynecology, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa (Dr. Singh), Ontario, Canada. Electronic address:


Endometriosis-associated pain (EAP) has a significant impact on the quality of life of those affected and their families. Recognizing that endometriosis is a chronic condition associated with an impairment in function and negative social impact, there is a shift toward reducing diagnostic delays and initiating timely management. This article provides a comprehensive and practical approach to the clinical diagnosis of EAP, which can subsequently facilitate prompt and directed treatment. The key components of the history, physical examination, and high-quality imaging to evaluate suspected EAP and related pain conditions are presented. Currently, biomarkers have limited utility in the diagnosis of endometriosis, but research in this area continues; development of a reliable noninvasive test for endometriosis may further improve early identification of this condition.


Endometriosis; Endometriosis biomarkers; Endometriosis diagnosis; Endometriosis imaging; Pelvic pain


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