Endometriosis: the next ten years

Several modalities can be employed in managing the patient with endometriosis, but the ultimate selection is determined by evaluating a number of criteria including age, extent of disease, severity of symptoms and pain. Scoring systems used in many clinical trials are based on the Revised American Fertility Society system but have their limitations. There is a possibility of using such innovations as receptor studies to individualize therapies in the future. Future research must also include dose-response studies, not only for the new GnRH agonists but also for danazol. These are essential to investigate efficacy. It may be that the different subtypes of endometriosis require quite dissimilar approaches to achieve the therapeutic goal. Despite advances in therapy for endometriosis, the disease remains largely a mystery in terms of its aetiology and pathogenesis, but we are drawing closer to refining our diagnostic and scoring techniques and individualizing our approach to therapy.