Endometriosis affects approximately 10% of women of reproductive age and is defined by the presence of endometrial-like tissue outside the uterine cavity. This ectopic tissue results in chronic inflammation, fibrosis, and adhesions, which contribute to pelvic pain, dysmenorrhoea, dyspareunia, and infertility. The condition presents in various forms—superficial peritoneal disease, deep infiltrating endometriosis (DIE), and ovarian endometriomas—and is often associated with comorbidities such as adenomyosis and chronic pelvic pain syndromes, making management complex.

Effective management requires a coordinated multidisciplinary approach. Diagnostic accuracy is critical and depends on the expertise of sonographers, radiologists, and gynaecologists skilled in transvaginal ultrasound and MRI for endometriosis mapping. Treatment options span non-pharmacological, medical, surgical, and interventional radiological modalities, and must be individualised to each patient’s symptoms, disease burden, fertility goals, and quality-of-life considerations.

Surgical management, particularly for deep infiltrating endometriosis, demands advanced laparoscopic proficiency. Surgeons must be experienced in complex pelvic dissection and excision techniques. Multispecialty surgical collaboration is often required, involving colorectal, urological, thoracic, and upper gastrointestinal surgeons to achieve complete and safe resection when disease extends beyond the reproductive tract.

Clinical nurse specialists are integral to care pathways, supporting medication adherence, symptom management, patient education, and follow-up. Multidisciplinary pain teams—including anaesthetists, psychologists, and gynaecologists—play a crucial role in addressing central sensitisation and chronic pelvic pain. Engagement with patient advocates enhances shared decision-making and ensures patient-centred care.

In recognition of these needs, we as a East and West Midlands team, established the Midlands Endometriosis Society to bring together professionals across disciplines involved in endometriosis care. Our collaborative mission is to improve standards of care through collaboration, continuing professional development, shared clinical insights, and support for research and audit. Our biannual meetings provide a forum for peer learning and aim to foster a collegial network that drives excellence in endometriosis management across the Midlands.

Lina Antoun

T Justin Clark