This guideline covers diagnosing and managing endometriosis. It aims to raise awareness of the symptoms of endometriosis, and to provide clear advice on what action to take when women and people with signs and symptoms first present in healthcare settings. It also provides advice on the range of treatments available.

This guideline updates and replaces the recommendations on endometriosis in NICE's guideline on fertility problems, which includes recommendations on fertility tests and treatments such as assisted reproduction.

In April 2024, we reviewed the evidence and made new and updated recommendations on treatment of endometriosis when fertility is a priority.

For information on related topics, see our women's and reproductive health summary page.


This guideline includes updated recommendations on:

It also includes recommendations on:

Who is it for?

  • Healthcare professionals
  • Commissioners and providers
  • Women and people with suspected or confirmed endometriosis, their families and carers

Is this guideline up to date?

Portfolio review May 2023: We have reviewed our guidelines portfolio to identify topics that we think will add the most value to the health and care system. The update on diagnosing endometriosis highlighted in the 2022 surveillance report will go ahead as planned. The update of recommendations on pain management post-surgery will not proceed as planned.

Guideline development process

How we develop NICE guidelines

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.