New Canadian Guidelines for Endometriosis: What Patients Need to Know
The Society of Obstetricians and Gynecologists of Canada (SOGC) has released updated clinical practice guidelines for managing endometriosis, emphasizing that care should be personalized, coordinated and focused on each patient’s goals.
Endometriosis affects many people of reproductive age and occurs when tissue similar to the lining of the uterus grows outside the uterus. It can cause pelvic pain, painful periods, pain with intercourse, bowel or bladder symptoms, fatigue and challenges with fertility.
The new SOGC guidelines highlight that endometriosis is not simply a gynecological condition — it is a chronic disease that may require long-term management involving physicians, specialists, pharmacists, fertility experts and other healthcare professionals. At Orleans Family Health Clinic, we recognize the importance of coordinated, patient-centred care for individuals living with chronic conditions such as endometriosis.
Endometriosis Treatment Should Be Personalized
The SOGC emphasizes that there is no single treatment approach that works for everyone. Healthcare providers should consider the severity and location of endometriosis, pain symptoms and impact on daily activities, fertility goals, previous treatments, lifestyle considerations, and patient preferences. The goal is not only to treat the disease but also to improve quality of life.
At OFHC, patients experiencing symptoms suggestive of endometriosis should discuss their concerns with their healthcare provider. Early assessment can help patients access appropriate investigations, symptom management and specialist referrals when needed.
Hormone Therapy: A Key Treatment Option
Hormonal therapy remains an important treatment option for managing endometriosis-related pain. The new guidelines recommend that patients who tolerate hormonal therapy should generally try treatment for at least three months before determining whether it is effective.
Treatment options may include combined hormonal contraceptives, progestin-based therapies, gonadotropin-releasing hormone (GnRH) medications, and other hormone-suppressing therapies. Each medication has different benefits and potential side effects, which is why treatment decisions should be individualized.
Protecting Bone Health During Hormonal Treatment
Some hormone therapies can affect bone density. The guidelines recommend that healthcare providers discuss bone health risks, calcium and vitamin D intake when appropriate, lifestyle factors that support healthy bones, and monitoring strategies for patients at higher risk. This is particularly important for adolescents and younger patients who may require long-term hormonal suppression.
Surgery: Understanding the Options
For some patients, surgery may be recommended. The SOGC guidelines highlight several important considerations.
Excision vs. ablation. Removing endometriosis lesions through excision surgery may provide better outcomes compared with simply destroying lesions through ablation.
Fertility considerations. Patients hoping to become pregnant should discuss fertility goals before surgery. The guidelines recommend using tools such as the Endometriosis Fertility Index to help estimate fertility outcomes after surgery.
Ovarian endometriomas. For ovarian cysts caused by endometriosis (endometriomas), cyst removal may improve symptoms and reduce recurrence, but surgery can also affect ovarian reserve. Patients should have a careful discussion with their healthcare team before proceeding.
Endometriosis Requires Long-Term Follow-Up
Endometriosis is often a chronic condition that requires ongoing management. A comprehensive care plan may include pain management, hormonal therapy, lifestyle support, mental health support when needed, physiotherapy, fertility planning, and specialist consultation. OFHC supports a team-based approach where family physicians coordinate care and help patients navigate referrals and long-term treatment decisions.
Improving Access to Specialized Endometriosis Care
The SOGC is calling for a healthcare system-wide approach to improve access to advanced imaging, specialized endometriosis centres, multidisciplinary care teams, and surgical expertise. The organization also recommends financial support for patients who need to travel to specialized centres, especially those requiring complex surgery for deep endometriosis.
When Should You Talk to Your Healthcare Provider?
Consider discussing your symptoms if you experience severe menstrual cramps affecting daily activities, pelvic pain that does not improve, pain during intercourse, chronic pelvic discomfort, difficulty becoming pregnant, or persistent bowel or bladder symptoms related to your cycle. Early evaluation can help patients receive appropriate care sooner.
OFHC Takeaway
The updated SOGC guidelines reinforce an important message: endometriosis care should be personalized, coordinated and focused on improving quality of life.
If you are experiencing symptoms of endometriosis, speak with your healthcare provider. Effective treatments are available, and a long-term care plan can help manage symptoms while supporting fertility and overall health.
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Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your healthcare provider first. Full Disclaimer.
