Indications for referral in endometriosis

Refer to a specialist endometriosis gynaecology service (if available) if the individual has:

• persistent and significant symptoms (see Symptoms of endometriosis)
• symptoms that do not respond to first-line treatment after 3 months
• a pelvic mass or nodule
• suspicion of bladder or bowel involvement with deep endometriosis.

Refer for fertility treatment for suspected or confirmed endometriosis if an individual is not able to conceive after 6 months of trying or is older than 35 years.

Other specialist input (ideally from a multidisciplinary team) may be required for individuals with complex needs, including from an endocrinologist, psychologist, pelvic physiotherapist or pain specialist.