Unstable patients require resuscitation and urgent surgical consultation. Stable patients with the presumptive diagnosis of endometriosis require gynecologic referral for long-term management. Medical management in the ED generally is restricted to pain control. Long-term medical therapy usually is suppressive and rarely curative of endometriosis because the recurrence rate is high after cessation of medications. Do not place patients on danazol or GnRH agonists unless they are monitored by a physician and have a laparoscopically confirmed diagnosis of endometriosis.
Ovulation suppression occurs with medical management.
Menses usually becomes suppressed. Medication management beyond pain control is outside the scope of emergency medicine. Gynecologic follow-up is required because endometriosis is progressive and can result in chronic pain and infertility. It does, however, preserve the potential for conception. Pregnancy is possible but depends upon the severity of the disease.