title: Pain in endometriosis: effectiveness of medical and surgical management.
abstract: OBJECTIVE
  Endometriosis is a common cause of chronic pelvic pain and has a detrimental effect on the quality of life for women affected with the condition. It is also clear that early diagnosis with prompt effective management does not always occur. This review will discuss the medical and surgical treatment options and support conclusions with randomized double blind placebo-controlled studies where possible.
  
  
  RESULTS
  Assessment of the pelvic pain associated with endometriosis can be categorized according to its relation to the menstrual cycle. Dysmenorrhoea and ovulatory pain occur with cyclical changes, as compared with chronic non-cyclic pain and deep dyspareunia. Dyskesia and urinary pain may have a relation to the menstrual cycle. The severity of pain symptoms, as well as the effect on the woman's quality of life, should be quantified. The preoperative symptoms can be compared with the operative findings and the stage of endometriosis according to the revised American Fertility Score.
  
  
  CONCLUSIONS
  Review of the current literature demonstrates that a combined medical and conservative surgical approach is beneficial for most women with endometriosis associated pelvic pain.
authors: The Fertility Centre, St Bartholomews Hospital, Barts and The London NHS Trust, London, UK. colin.davis@bartsandthelondon.nhs.uk
authors: Colin J
authors: CJ
authors: Davis
authors: Lindsay
authors: L
authors: McMillan
mesh_terms: D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D017699:Pelvic Pain / Q000209:etiology / Q000628:therapy*