ACOG Updates Endometriosis Diagnosis Guidelines, Emphasizing Earlier Detection

Washington, D.C.—The American College of Obstetricians & Gynecologists (ACOG) has released updated clinical guidance on endometriosis, focusing on improving diagnostic accuracy and reducing the significant delays patients often experience in receiving a diagnosis. The new guidance, published in March 2026, emphasizes clinical diagnosis and targeted imaging, although explicitly advising against the use of blood tests, urine tests, or endometrial biomarkers for diagnosis at this time. Diagnosis of Endometriosis: ACOG Clinical Practice Guide

Understanding Endometriosis

Endometriosis is a chronic inflammatory disorder characterized by the presence of endometrial-like tissue lesions outside the uterus. ACOG Publishes New Endometriosis Clinical Guidance This can lead to chronic pain, infertility and a diminished quality of life for those affected. The pain associated with endometriosis can be severe and debilitating, impacting all aspects of a patient’s life.

Key Changes in ACOG’s Guidance

A significant issue in endometriosis care is the diagnostic delay, with individuals often waiting between four and eleven years from the onset of symptoms to receiving a diagnosis. ACOG Publishes New Endometriosis Clinical Guidance ACOG’s new recommendations aim to address this by:

• Prioritizing Clinical Diagnosis: Doctors can now diagnose suspected endometriosis based on a patient’s symptoms, medical history, and a physical examination. New ACOG Guidelines Change How Endometriosis Is Diagnosed Previously, laparoscopic surgery was often considered necessary for confirmation.
• Targeted Imaging: Utilizing imaging techniques to facilitate identify potential endometriosis lesions.
• Symptom-Based Evaluation: A thorough evaluation of a patient’s symptoms is crucial for accurate diagnosis.

Symptoms of Endometriosis

Common symptoms of endometriosis include:

• Chronic pelvic pain
• Painful periods (dysmenorrhea)
• Pain during intercourse (dyspareunia)
• Painful urination or bowel movements
• Gastrointestinal symptoms such as bloating or constipation
• Fatigue
• Difficulty getting pregnant

It’s important to note that symptoms can vary widely and may overlap with other conditions, making diagnosis challenging. New ACOG Guidelines Change How Endometriosis Is Diagnosed

What the Guidelines Mean for Patients

ACOG President Steven J. Fleischman, MD, MBA, FACOG, expressed hope that the expanded clinical guidance will empower clinicians to diagnose endometriosis more confidently and initiate treatment sooner. ACOG Publishes New Endometriosis Clinical Guidance Earlier diagnosis can facilitate access to necessary clinical care, patient education resources, and support groups.

Biomarkers and Future Research

Despite ongoing research, ACOG currently does not recommend using blood tests, urine tests, or endometrial biomarkers to diagnose endometriosis. ACOG Endometriosis Guidelines However, research continues to identify potential biomarkers that could simplify the diagnostic process in the future.

Looking Ahead

ACOG is developing additional guidance on the management of endometriosis, building upon these new diagnostic recommendations. This comprehensive approach aims to improve the lives of individuals affected by this chronic condition by shortening the time to diagnosis and improving access to effective care.