Summary of Recommendations

Document Overview

Design and created by Guideline Central in participation with the Society of Obstetricians and Gynaecologists of Canada.

Diagnosis and Impact of Endometriosis

Society of Obstetricians and Gynaecologists of Canada

Publication Date: Mar 28, 2024

Page Last Updated: May 5, 2026

RECOMMENDATIONS

Health care providers should provide a patient-centred approach to the diagnosis of endometriosis, acknowledging and believing the patient’s experiences of their symptoms (strong, moderate).
Health care providers must be sensitive to the needs of patients from diverse populations, including racialized and marginalized communities, and use trauma-informed approaches with all patients (strong, moderate).
To assess the possibility of endometriosis, a complete history and physical examination should be undertaken with particular attention to symptoms and signs of deep endometriosis to localize pain and identify other conditions associated with chronic pelvic pain (strong, moderate).
Health care providers should consider a diagnosis of endometriosis for patients presenting with dysmenorrhea, pelvic pain, and/or infertility (strong, high).
To perform and/or report the results of an advanced ultrasound or MRI for endometriosis, the health care provider must have specific training in abdominal/pelvic or gynaecologic imaging (strong, moderate).
Basic abdominal and transvaginal ultrasound should be used to identify ovarian endometriomas and as an investigative tool for other causes of pelvic pain, even if the pelvic and/or abdominal exam was assessed to be normal (strong, high).
Advanced ultrasound for endometriosis, including pelvic and transvaginal ultrasound with limited abdominal ultrasound, should be used to assist with the detection of ovarian and deep endometriosis in patients at risk. (strong, moderate).
Health care providers should order a pelvic MRI if advanced ultrasound is not possible or unavailable and there is a high degree of suspicion of ovarian endometriomas and deep endometriosis (strong, moderate).
CT scanning should not be used as a primary investigative tool to diagnose endometriosis, though it may be considered for assessment of acute pain unrelated to endometriosis (strong, high).
Health care providers should not use biomarkers (individual or panels) to diagnose endometriosis, until more research and validation is available (strong, high).

Document Overview

Document Title: Diagnosis and Impact of Endometriosis

Authoring Society: Society of Obstetricians and Gynaecologists of Canada

Document Publication Date: Mar 28, 2024

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: Canada

Full Text Freely Available: No

Full Text Guideline: www.jogc.com/article/S1701-2163(24)00261-5/abstract

Source Citation: Singh SS, Allaire C, Al-Nourhji O, Bougie O, Bridge-Cook P, Duigenan S, Kroft J, Lemyre M, Leonardi M, Leyland N, Maheux-Lacroix S, Wessels J, Wahl K, Yong PJ. Guideline No. 449: Diagnosis and Impact of Endometriosis - A Canadian Guideline. J Obstet Gynaecol Can. 2024 May;46(5):102450. doi: 10.1016/j.jogc.2024.102450. Epub 2024 Mar 28. PMID: 38555044.

Document Scope, Criteria, and Use Cases

Document Objectives: To provide a contemporary approach to the understanding of the impact and methods for the diagnosis of endometriosis.

Scope: Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D004715 - Endometriosis

Keywords: Endometriosis, biomarkers

Target Patient Population: Patients with endometriosis

Target Provider Population: Health care providers involved in the care of those with endometriosis

Inclusion Criteria: Male, Female, Adult, Older Adult

Health Care Settings: Ambulatory

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Diagnosis and Impact of Endometriosis

Summary of Recommendations

SUMMARY STATEMENTS

RECOMMENDATIONS

Document Overview

Document Scope, Criteria, and Use Cases