--- title: "World Endometriosis Society: endometriosis classification. | Sutter Health" description: "Large, global, consortium of 29 major stakeholding organizations from 19 countries convened to evaluate evidence on endometriosis classification." url: "https://www.sutterhealth.org/research/publications/world-endometriosis-society-endometriosis-classif-1055312517" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. World Endometriosis Society: endometriosis classification. # World Endometriosis Society consensus on the classification of endometriosis. Johnson NP, Hummelshoj L, Adamson GD, Keckstein J, Taylor HS, Abrao MS, Bush D, Kiesel L, Tamimi R, Sharpe-Timms KL, Rombauts L, & Giudice LC; for the World Endometriosis Society Sao Paulo Consortium. _Hum Reprod. \[Epub ahead of print\]_ 2016-12-05 ## Abstract STUDY QUESTION: What is the global consensus on the classification of endometriosis that considers the views of women with endometriosis? SUMMARY ANSWER: We have produced an international consensus statement on the classification of endometriosis through systematic appraisal of evidence and a consensus process that included representatives of national and international, medical and non-medical societies, patient organizations, and companies with an interest in endometriosis. WHAT IS KNOWN ALREADY: Classification systems of endometriosis, developed by several professional organizations, traditionally have been based on lesion appearance, pelvic adhesions, and anatomic location of disease. One system predicts fertility outcome and none predicts pelvic pain, response to medications, disease recurrence, risks for associated disorders, quality of life measures, and other endpoints important to women and health care providers for guiding appropriate therapeutic options and prognosis. STUDY DESIGN, SIZE, DURATION: A consensus meeting, in conjunction with pre- and post-meeting processes, was undertaken. PARTICIPANTS/MATERIALS, SETTING, METHODS: A consensus meeting was held on 30 April 2014 in conjunction with the World Endometriosis Society's 12th World Congress on Endometriosis. Rigorous pre- and post-meeting processes, involving 55 representatives of 29 national and international, medical and non-medical organizations from a range of disciplines, led to this consensus statement. MAIN RESULTS AND THE ROLE OF CHANCE: A total of 28 consensus statements were made. Of all, 10 statements had unanimous consensus, however none of the statements was made without expression of a caveat about the strength of the statement or the statement itself. Two statements did not achieve majority consensus. The statements covered women's priorities, aspects of classification, impact of low resources, as well as all the major classification systems for endometriosis. Until better classification systems are developed, we propose a classification toolbox (that includes the revised American Society for Reproductive Medicine and, where appropriate, the Enzian and Endometriosis Fertility Index staging systems), that may be used by all surgeons in each case of surgery undertaken for women with endometriosis. We also propose wider use of the World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonisation Project surgical and clinical data collection tools for research to improve classification of endometriosis in the future, of particular relevance when surgery is not undertaken. LIMITATIONS, REASONS FOR CAUTION: This consensus process differed from that of formal guideline development, although based on the same available evidence. A different group of international experts from those participating in this process may have yielded subtly different consensus statements. WIDER IMPLICATIONS OF THE FINDINGS: This is the first time that a large, global, consortium-representing 29 major stake-holding organizations, from 19 countries - has convened to systematically evaluate the best available evidence on the classification of endometriosis and reach consensus. In addition to 21 international medical organizations and companies, representatives from eight national endometriosis organizations were involved, including lay support groups, thus generating and including input from women who suffer from endometriosis in an endeavour to keep uppermost the goal of optimizing quality of life for women with endometriosis. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/27920089) ## Research topics - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Obstetrics and Gynecology](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Obstetrics+and+Gynecology%5C%22%22) - [Women's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Women%27s+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [The International Glossary on Infertility and Fertility Care, 2017.](https://www.sutterhealth.org/research/publications/internatl-glossary-infertility-fertility-care-1055312335) Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, Rienzi L, Sunde A, Schmidt L, Cooke ID, Simpson JL, van der Poel S. Fertil Steril. pii: S0015-0282(17)30429-6. doi: 10.1016/j.fertnstert.2017.06.005. \[Epub ahead of print\] 2017 Jul 28 - Publication ### [Selective serotonin reuptake inhibitors for premenstrual syndrome and premenstrual dysphoric disorder: a meta-analysis.](https://www.sutterhealth.org/research/publications/ssris-for-premenstrual-syndrome-meta-analysis-1055312627) Shah NR, Jones JB, Aperi J, Shemtov R, Karne A, Borenstein J. Obstet Gynecol. 111(5):1175-82. doi: 10.1097/AOG.0b013e31816fd73b. 2008 May 01 - Publication ### [An evidence-based approach to assessing surgical versus clinical diagnosis of symptomatic endometriosis.](https://www.sutterhealth.org/research/publications/surgical-vs-clinical-dx-of-endometriosis-1055312364) Taylor HS, Adamson GD, Diamond MP, Goldstein SR, Horne AW, Missmer SA, Snabes MC, Surrey E, Taylor RN. Int J Gynaecol Obstet. 2018 May 5. doi: 10.1002/ijgo.12521. \[Epub ahead of print\] Review. 2018 May 05 - Publication ### [An open letter to the Food and Drug Administration regarding the use of morcellation procedures in women having surgery for presumed uterine myomas.](https://www.sutterhealth.org/research/publications/to-fda-re-morcellation-uterine-myomas-1055312488) Parker W, Berek JS, Pritts E, et al. J Minim Invasive Gynecol. pii: S1553-4650(15)01732-X. doi: 10.1016/j.jmig.2015.12.012. \[Epub ahead of print\] 2016 Jan 08 - Publication ### [Redefining risk and benefit: understanding the decision to undergo contralateral prophylactic mastectomy.](https://www.sutterhealth.org/research/publications/decsion-for-contralateral-prophylactic-mastectomy-1055312294) Rendle KA, Halley MC, May SG, Frosch DL. Qual Health Res. 25(9):1251-9. doi: 10.1177/1049732314557085. Epub 2014 Nov 4. 2015 Sep 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/world-endometriosis-society-endometriosis-classif-1055312517#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"World Endometriosis Society: endometriosis classification."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/world-endometriosis-society-endometriosis-classif-1055312517#medicalscholarlyarticle","name":"World Endometriosis Society consensus on the classification of endometriosis.","headline":"World Endometriosis Society: endometriosis classification.","abstract":"STUDY QUESTION: What is the global consensus on the classification of endometriosis that considers the views of women with endometriosis? SUMMARY ANSWER: We have produced an international consensus statement on the classification of endometriosis through systematic appraisal of evidence and a consensus process that included representatives of national and international, medical and non-medical societies, patient organizations, and companies with an interest in endometriosis. WHAT IS KNOWN ALREADY: Classification systems of endometriosis, developed by several professional organizations, traditionally have been based on lesion appearance, pelvic adhesions, and anatomic location of disease. One system predicts fertility outcome and none predicts pelvic pain, response to medications, disease recurrence, risks for associated disorders, quality of life measures, and other endpoints important to women and health care providers for guiding appropriate therapeutic options and prognosis. STUDY DESIGN, SIZE, DURATION: A consensus meeting, in conjunction with pre- and post-meeting processes, was undertaken. PARTICIPANTS/MATERIALS, SETTING, METHODS: A consensus meeting was held on 30 April 2014 in conjunction with the World Endometriosis Society's 12th World Congress on Endometriosis. Rigorous pre- and post-meeting processes, involving 55 representatives of 29 national and international, medical and non-medical organizations from a range of disciplines, led to this consensus statement. MAIN RESULTS AND THE ROLE OF CHANCE: A total of 28 consensus statements were made. Of all, 10 statements had unanimous consensus, however none of the statements was made without expression of a caveat about the strength of the statement or the statement itself. Two statements did not achieve majority consensus. The statements covered women's priorities, aspects of classification, impact of low resources, as well as all the major classification systems for endometriosis. Until better classification systems are developed, we propose a classification toolbox (that includes the revised American Society for Reproductive Medicine and, where appropriate, the Enzian and Endometriosis Fertility Index staging systems), that may be used by all surgeons in each case of surgery undertaken for women with endometriosis. We also propose wider use of the World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonisation Project surgical and clinical data collection tools for research to improve classification of endometriosis in the future, of particular relevance when surgery is not undertaken. LIMITATIONS, REASONS FOR CAUTION: This consensus process differed from that of formal guideline development, although based on the same available evidence. A different group of international experts from those participating in this process may have yielded subtly different consensus statements. WIDER IMPLICATIONS OF THE FINDINGS: This is the first time that a large, global, consortium-representing 29 major stake-holding organizations, from 19 countries - has convened to systematically evaluate the best available evidence on the classification of endometriosis and reach consensus. In addition to 21 international medical organizations and companies, representatives from eight national endometriosis organizations were involved, including lay support groups, thus generating and including input from women who suffer from endometriosis in an endeavour to keep uppermost the goal of optimizing quality of life for women with endometriosis.","description":"Large, global, consortium of 29 major stakeholding organizations from 19 countries convened to evaluate evidence on endometriosis classification.","keywords":["Disease Management","Health Services","Obstetrics and Gynecology","Women's Health"],"datePublished":"2016-12-05","url":"https://www.sutterhealth.org/research/publications/world-endometriosis-society-endometriosis-classif-1055312517","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"27920089"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/27920089/"],"isPartOf":{"@type":"Periodical","name":"Hum Reprod"},"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Disease Management","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Disease+Management%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Obstetrics and Gynecology","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Obstetrics+and+Gynecology%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Women's Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Women%27s+Health%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/world-endometriosis-society-endometriosis-classif-1055312517","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/world-endometriosis-society-endometriosis-classif-1055312517#breadcrumblist"}}} ```