Endometriosis: recent advances that could accelerate diagnosis and improve care

The reframing of endometriosis as a multi-system disorder, with emphasis on treating symptoms most relevant/important to individuals, has highlighted the need for more diverse and personalised approaches to care.Genomic studies have identified shared genetic factors in the aetiology of endometriosis and several comorbid conditions, which have improved our understanding of disease aetiology and offered opportunities for drug repurposing.Increased biosynthesis of inflammatory mediators has been identified as a key factor in driving disease processes and increased pain, leading to the design and testing of therapies targeting these pathways.The gut–microbiota–brain axis has recently emerged as a key player in neurological and pain pathways but remains under-explored in the context of endometriosis-associated symptoms. Endometriosis is a common disorder associated with pain, gastrointestinal and urinary symptoms, infertility, and fatigue. It is defined by the presence of endometrial-like lesions found predominantly in the pelvis. Mechanisms that contribute to disease aetiology include changes in hormonal, inflammatory, and pain pathways. In this article, we focus on recent developments in imaging technologies, on our improved understanding of mechanisms contributing to infertility, on drug therapies that are in clinical trials, and on insights from studies on the gut that offer potential to support self-management strategies. We postulate that improvements in the quality of life of patients will be accelerated by reframing endometriosis as a multi-system disorder and learning from treatments targeting symptoms shared between endometriosis, neuroinflammatory, and gastrointestinal disorders. Endometriosis is a common disorder associated with pain, gastrointestinal and urinary symptoms, infertility, and fatigue. It is defined by the presence of endometrial-like lesions found predominantly in the pelvis. Mechanisms that contribute to disease aetiology include changes in hormonal, inflammatory, and pain pathways. In this article, we focus on recent developments in imaging technologies, on our improved understanding of mechanisms contributing to infertility, on drug therapies that are in clinical trials, and on insights from studies on the gut that offer potential to support self-management strategies. We postulate that improvements in the quality of life of patients will be accelerated by reframing endometriosis as a multi-system disorder and learning from treatmen