Improving Shared Decision-Making in Endometriosis Care

In "Improving Shared Decision-Making in Endometriosis Care," the panel opens Section 3 by asking why medical management still lags in everyday practice.

Dr. Davitt explains why medical management of endometriosis remains underutilized among general OBGYNs, primary care providers, and nurse practitioners. He traces it back to the same core issue discussed earlier in the series: without comfort reaching a clinical diagnosis, there is little room to progress toward more robust medical management. As more providers become familiar with the newer ACOG recommendations permitting a clinical diagnosis, he expects that recognition to translate directly into conversations about medical therapy, so primary care providers can feel confident diagnosing, recommending treatment, and following patients to ensure they achieve the results they deserve. Dr. Kho then turns to the most common misconceptions patients hold about medical and hormonal management. Many patients arrive reluctant to take any hormones or medications at all, and addressing that resistance starts with explaining what endometriosis actually is and why hormonal treatment makes physiologic sense, which the panel says often builds enough understanding to increase a patient's willingness to try medical therapy. Dr. Lukes notes the disease can persist across a woman's entire reproductive years, making timely intervention essential even as the balance between medication and surgery continues to shift. Dr. Davitt then describes his approach to shared decision-making with patients who have waited years for a diagnosis. He starts by listening fully to a patient's story, including any past dismissal, since many patients hesitate because medical therapy was once offered as their only option and felt like their symptoms were being brushed aside. He acknowledges upfront that treatment may involve some trial and learning, and commits to staying with the patient through the process regardless of early setbacks. In the panel’s closing thoughts, they call this an exciting time in women's health given advances in diagnosis, and hope the discussion encourages more providers to engage earlier with patients experiencing pelvic pain.

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