Medical management of endometriosis: what the radiologist needs to know

review OA: closed CC0 ⤵ 3 in-corpus citations
AI-generated summary by claude@2026-06+body, 2026-06-07

This review covers current medical therapies for endometriosis-related pain and their potential imaging findings to aid radiologists in evaluating disease and treatment response.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text

This paper reviews current medical therapies used to manage endometriosis-related pain and focuses on what imaging/radiology professionals should know about monitoring disease. It discusses how improved MRI techniques increase detection of subtle endometriosis findings and how radiologists may evaluate baseline disease and look for imaging response or stability after treatment using medication regimens. A stated caveat is that the review is not an original efficacy trial and emphasizes expected imaging findings and knowledge for follow-up rather than providing new comparative clinical outcomes. This paper is centrally about endometriosis — it provides radiology-focused guidance on medical management therapies and anticipated MRI/assessment findings for endometriosis-related pain.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Full text 8,406 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Abstract

The role of the radiologist in the diagnosis and management of patients with endometriosis is increasing. Improvement in MRI imaging techniques has improved detection rate of subtle manifestations of endometriosis by radiologists. Therefore, the role of imaging in the diagnosis and follow-up after treatment is also likely to increase. Knowledge of new medical management pathways used in treating patients with endometriosis-related pain is important. The knowledge of various medication regimens will allow radiologists to continue to evaluate baseline disease, and to potentially assess for imaging response/stability to these medications. This article will review the current medical therapies in use in the management of endometriosis-related pain and describe potential imaging-related findings expected with these therapies. Similar content being viewed by others

References

Bazot M, Bharwani N, Huchon C, Kinkel K, Cunha TM, Guerra A, Manganaro L, Bunesch L, Kido A, Togashi K, Thomassin-Naggara I, Rockall AG (2017) European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis. Eur Radiol 27 (7):2765-2775. https://doi.org/10.1007/s00330-016-4673-z Guerriero S, Ajossa S, Minguez JA, Jurado M, Mais V, Melis GB, Alcazar JL (2015) Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in uterosacral ligaments, rectovaginal septum, vagina and bladder: systematic review and meta-analysis. Ultrasound Obstet Gynecol 46 (5):534-545. https://doi.org/10.1002/uog.15667 Guerriero S, Pascual MA, Ajossa S, Rodriguez I, Zajicek M, Rolla M, Rams Llop N, Yulzari V, Bardin R, Buonomo F, Comparetto O, Perniciano M, Saba L, Mais V, Alcazar JL (2019) Learning curve for ultrasonographic diagnosis of deep infiltrating endometriosis using structured offline training program. Ultrasound Obstet Gynecol 54 (2):262-269. https://doi.org/10.1002/uog.20176 Saba L, Ajossa S, Ledda G, Balestrieri A, Schirru F, De Cecco CN, Suri JS, Melis GB, Lavra F, Guerriero S (2019) Does the clinical information play a role in the magnetic resonance diagnostic confidence analysis of ovarian and deep endometriosis? Br J Radiol 92 (1096):20180548. https://doi.org/10.1259/bjr.20180548 Bazot M, Darai E (2017) Diagnosis of deep endometriosis: clinical examination, ultrasonography, magnetic resonance imaging, and other techniques. Fertil Steril 108 (6):886-894. https://doi.org/10.1016/j.fertnstert.2017.10.026 Bazot M, Bornier C, Dubernard G, Roseau G, Cortez A, Darai E (2007) Accuracy of magnetic resonance imaging and rectal endoscopic sonography for the prediction of location of deep pelvic endometriosis. Hum Reprod 22 (5):1457-1463. https://doi.org/10.1093/humrep/dem008 Feldman MK, VanBuren WM, Barnard H, Taffel MT, Kho RM (2019) Systematic interpretation and structured reporting for pelvic magnetic resonance imaging studies in patients with endometriosis: value added for improved patient care. Abdom Radiol (NY). https://doi.org/10.1007/s00261-019-02182-1 Mattos LA, Goncalves MO, Andres MP, Young SW, Feldman M, Abrao MS, Kho RM (2019) Structured US and MRI imaging report for patients with suspected endometriosis: Guide for Imagers and Clinicians. J Minim Invasive Gynecol. https://doi.org/10.1016/j.jmig.2019.02.017 Bazot M, Darai E, Hourani R, Thomassin I, Cortez A, Uzan S, Buy JN (2004) Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 232 (2):379-389. https://doi.org/10.1148/radiol.2322030762 Schroder AK, Diedrich K, Ludwig M (2004) Medical management of endometriosis: a systematic review. IDrugs 7 (5):451-463 Rafique S, Decherney AH (2017) Medical Management of Endometriosis. Clin Obstet Gynecol 60 (3):485-496. https://doi.org/10.1097/GRF.0000000000000292 Guo SW (2009) Recurrence of endometriosis and its control. Hum Reprod Update 15 (4):441-461. https://doi.org/10.1093/humupd/dmp007 Noda T, Murakami T (2001) [Management of recurrent endometriosis]. Nihon Rinsho 59 Suppl 1:187-191 Dmowski WP, Scholer HF, Mahesh VB, Greenblatt RB (1971) Danazol--a synthetic steroid derivative with interesting physiologic properties. Fertil Steril 22 (1):9-18. https://doi.org/10.1016/s0015-0282(16)37981-x Selak V, Farquhar C, Prentice A, Singla A (2007) Danazol for pelvic pain associated with endometriosis. Cochrane Database Syst Rev (4):CD000068. https://doi.org/10.1002/14651858.cd000068.pub2 Telimaa S, Ronnberg L, Kauppila A (1987) Placebo-controlled comparison of danazol and high-dose medroxyprogesterone acetate in the treatment of endometriosis after conservative surgery. Gynecol Endocrinol 1 (4):363-371 Boothroyd CV, Lepre F (1990) Permanent voice change resulting from Danazol therapy. Aust N Z J Obstet Gynaecol 30(3):275–276.Boothroyd CV, Lepre F (1990) Permanent voice change resulting from Danazol therapy. Aust N Z J Obstet Gynaecol 30 (3):275-276. https://doi.org/10.1111/j.1479-828x.1990.tb03232.x PPractice Committee of the American Society for Reproductive M (2014) Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertil Steril 101 (4):927-935. https://doi.org/10.1016/j.fertnstert.2014.02.012 Kupker W, Felberbaum RE, Krapp M, Schill T, Malik E, Diedrich K (2002) Use of GnRH antagonists in the treatment of endometriosis. Reprod Biomed Online 5 (1):12-16. https://doi.org/10.1016/s1472-6483(10)61590-8 Takayama K, Zeitoun K, Gunby RT, Sasano H, Carr BR, Bulun SE (1998) Treatment of severe postmenopausal endometriosis with an aromatase inhibitor. Fertil Steril 69 (4):709-713. https://doi.org/10.1016/s0015-0282(98)00022-3 Guzick DS, Huang LS, Broadman BA, Nealon M, Hornstein MD (2011) Randomized trial of leuprolide versus continuous oral contraceptives in the treatment of endometriosis-associated pelvic pain. Fertil Steril 95 (5):1568-1573. https://doi.org/10.1016/j.fertnstert.2011.01.027 Harada T, Kosaka S, Elliesen J, Yasuda M, Ito M, Momoeda M (2017) Ethinylestradiol 20 mug/drospirenone 3 mg in a flexible extended regimen for the management of endometriosis-associated pelvic pain: a randomized controlled trial. Fertil Steril 108 (5):798-805. https://doi.org/10.1016/j.fertnstert.2017.07.1165 Harada T, Momoeda M, Taketani Y, Hoshiai H, Terakawa N (2008) Low-dose oral contraceptive pill for dysmenorrhea associated with endometriosis: a placebo-controlled, double-blind, randomized trial. Fertil Steril 90 (5):1583-1588 https://doi.org/10.1016/j.fertnstert.2007.08.051 Vessey MP, Villard-Mackintosh L, Painter R (1993) Epidemiology of endometriosis in women attending family planning clinics. BMJ 306 (6871):182-184. https://doi.org/10.1136/bmj.306.6871.182 Olive DL (2003) Medical therapy of endometriosis. Semin Reprod Med 21 (2):209-222. https://doi.org/10.1055/s-2003-41327 Sagsveen M, Farmer JE, Prentice A, Breeze A (2003) Gonadotrophin-releasing hormone analogues for endometriosis: bone mineral density. Cochrane Database Syst Rev (4):CD001297. https://doi.org/10.1002/14651858.cd001297 Alkatout I, Mettler L, Beteta C, Hedderich J, Jonat W, Schollmeyer T, Salmassi A (2013) Combined surgical and hormone therapy for endometriosis is the most effective treatment: prospective, randomized, controlled trial. J Minim Invasive Gynecol 20 (4):473-481. https://doi.org/10.1016/j.jmig.2013.01.019 Taylor HS, Giudice LC, Lessey BA, Abrao MS, Kotarski J, Archer DF, Diamond MP, Surrey E, Johnson NP, Watts NB, Gallagher JC, Simon JA, Carr BR, Dmowski WP, Leyland N, Rowan JP, Duan WR, Ng J, Schwefel B, Thomas JW, Jain RI, Chwalisz K (2017) Treatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist. N Engl J Med 377 (1):28-40. https://doi.org/10.1056/NEJMoa1700089 Noble LS, Simpson ER, Johns A, Bulun SE (1996) Aromatase expression in endometriosis. J Clin Endocrinol Metab 81 (1):174-179. https://doi.org/10.1210/jcem.81.1.8550748 Author information Authors and Affiliations Corresponding author Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Hindman, N., Eswar, C., Huang, K. et al. Medical management of endometriosis: what the radiologist needs to know. Abdom Radiol 45, 1866–1871 (2020). https://doi.org/10.1007/s00261-020-02507-5 Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00261-020-02507-5

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Female Humans Magnetic Resonance Imaging Pain Radiologists

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (29)

Cited by (3)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-13T22:22:05.164793+00:00
License: CC0 · commercial use OK