References

Agarwal SK, Chapron C, Giudice LC Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol. 2019; 220:(4)354.e1-354.e12 https://doi.org/10.1016/j.ajog.2018.12.039

Byrne D, Curnow T, Smith P, Cutner A, Saridogan E, Clark TJ Laparoscopic excision of deep rectovaginal endometriosis in BSGE endometriosis centres: a multicentre prospective cohort study. BMJ Open. 2018; 8:(4) https://doi.org/10.1136/bmjopen-2017-018924

Culley L, Law C, Hudson N The social and psychological impact of endometriosis on women's lives: a critical narrative review. Hum Reprod Update. 2013; 19:(6)625-639 https://doi.org/10.1093/humupd/dmt027

Culley L, Law C, Hudson N A qualitative study of the impact of endometriosis on male partners. Hum Reprod. 2017; 32:(8)1667-1673 https://doi.org/10.1093/humrep/dex221

Dunselman GAJ, Vermeulen N, Becker C European Society of Human Reproduction and Embryology. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014; 29:(3)400-412 https://doi.org/10.1093/humrep/det457

European Society of Human Reproduction and Embryology. Management of women with endometriosis. 2013. https://www.eshre.eu/guidelines-and-legal/guidelines/endometriosis-guideline.aspx (accessed 21 November 2019)

Faculty of Sexual and Reproductive Healthcare. Combined Hormonal Contraception. 2019. https://www.fsrh.org/standards-and-guidance/documents/combined-hormonal-contraception/ (accessed 21 November 2019)

Friedl F, Riedl D, Fessler S Impact of endometriosis on quality of life, anxiety, and depression: an Austrian perspective. Arch Gynecol Obstet. 2015; 292:(6)1393-1399 https://doi.org/10.1007/s00404-015-3789-8

Hickey M, Ballard K, Farquhar C. Endometriosis. BMJ. 2014; 348:(mar19 5) https://doi.org/10.1136/bmj.g1752

Hudelist G, Fritzer N, Thomas A Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod. 2012; 27:(12)3412-3416 https://doi.org/10.1093/humrep/des316

Kennedy S, Koninckx P. Endometriosis. In: Edmonds DK (eds). Chichester: Wiley-Blackwell;

Laganà AS, Condemi I, Retto G Analysis of psychopathological comorbidity behind the common symptoms and signs of endometriosis. Eur J Obstet Gynecol Reprod Biol. 2015; 194:30-33 https://doi.org/10.1016/j.ejogrb.2015.08.015

Machairiotis N, Stylianaki A, Dryllis G Extrapelvic endometriosis: a rare entity or an under diagnosed condition?. Diagn Pathol. 2013; 8:(1) https://doi.org/10.1186/1746-1596-8-194

National Institute for Health and Care Excellence. Endometriosis: diagnosis and management. 2017a. https://www.nice.org.uk/guidance/ng73 (accessed 21 November 2019)

National Institute for Health and Care Excellence. Patient decision aid: Hormone treatment for endometriosis symptoms – what are my options?. 2017b. https://www.nice.org.uk/guidance/ng73/resources/patient-decision-aid-hormone-treatment-for-endometriosis-symptoms-what-are-my-options-pdf-4595573197 (accessed 21 November 2019)

National Institute for Health and Care Excellence. Endometriosis: Quality standard [QS172]. 2018. https://www.nice.org.uk/guidance/qs172 (accessed 21 November 2019)

Pluchino N, Wenger JM, Petignat P Sexual function in endometriosis patients and their partners: effect of the disease and consequences of treatment. Hum Reprod Update. 2016; 22:(6)762-774 https://doi.org/10.1093/humupd/dmw031

Proctor ML, Murphy PA. Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database Systematic Review. 2001; (2)

Royal College of Nursing. Endometriosis fact sheet. 2018. https://www.rcn.org.uk/professional-development/publications/pub-007240 (accessed 21 November 2019)

Simoens S, Dunselman G, Dirksen C The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres. Hum Reprod. 2012; 27:(5)1292-1299 https://doi.org/10.1093/humrep/des073

Tanbo T, Fedorcsak P. Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta Obstet Gynecol Scand. 2017; 96:(6)659-667 https://doi.org/10.1111/aogs.13082

Vercellini P, Barbara G, Abbiati A, Somigliana E, Viganò P, Fedele L. Repetitive surgery for recurrent symptomatic endometriosis: what to do?. Eur J Obstet Gynecol Reprod Biol. 2009; 146:(1)15-21 https://doi.org/10.1016/j.ejogrb.2009.05.007

World Endometriosis Society and the World Endometriosis Research Foundation. Facts about endometriosis. 2012. http://endometriosis.org/resources/articles/facts-about-endometriosis/ (accessed 21 November 2019)

Understanding the NICE guidance on endometriosis

02 January 2020
Volume 31 · Issue 1

Abstract

Wendy Norton and Debby Holloway provide an overview of endometriosis and identify the role of the practice nurse in supporting women with this diagnosis through their patient journey, referencing best practice from NICE guidelines

Endometriosis is a long-term gynaecological condition where endometrial tissue forms lesions outside the uterus, resulting in internal bleeding, inflammation, fibrosis, and adhesion formation. The condition is estimated to affect between 2 and 10% of women in the general population, but up to 50% of women with infertility, and can have a significant impact on women's, and their partners', lives. Endometriosis is often misunderstood and misdiagnosed, leading to reported lengthy delays in achieving a correct diagnosis. In 2017 and 2018, the National Institute for Health and Care Excellence (NICE) released guidelines and quality standards on managing endometriosis. Nurses working in primary care services play an important role in raising awareness of this condition and providing holistic, individualised care for women with endometriosis.

Endometriosis is a gynaecological disorder that is estimated to affect between 2 and 10% of women in the general population, but up to 50% of women with infertility (European Society of Human Reproduction and Embryology [ESHRE], 2013). However, the true prevalence is difficult to estimate due to the condition's uncertain and enigmatic nature. Endometriosis is complex and multifactorial with evidence suggesting that care can be delayed due to health care practitioners' lack of awareness and understanding of the condition, leading to a reported average delay in diagnosis of 5–8.9 years (Culley et al, 2013). In 2017 and 2018 the National Institute for Health and Care Excellence (NICE) released guidelines on managing suspected endometriosis and accompanying quality standards for prioritising care improvement (NICE, 2017a; 2018). Nurses working in primary care services can support women with suspected endometriosis by having an understanding of this condition and the range of presenting symptoms to facilitate a timely referral to specialist services.

Register now to continue reading

Thank you for visiting Practice Nursing and reading some of our peer-reviewed resources for general practice nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • New content and clinical newsletter updates each month