{
  "abstract": "Background\n\nDespite the availability of endometriosis care guidelines from multiple governmental and professional organisations, their global applicability and recommendations have been insufficiently examined. This scoping review examines endometriosis guidelines worldwide, evaluating their availability, target audiences and populations, methodologies, and clinical recommendations, building on a previous review of region-specific endometriosis care guidance.Methods\n\nWe searched PubMed, EMBASE, and Scopus from inception through October 2025 without language, publication date, or geographic location restrictions. Additional grey literature searches were conducted through March 2026. Eligible guidelines addressed individuals with suspected or confirmed endometriosis of any age, including adolescent-specific guidance and recommendations incorporating adenomyosis.Results\n\nA total of 47 guidelines were included, comprising 28 English-language and 19 non-English-language guidelines from multiple regions. The findings reveal marked regional inequities: most guidelines originate from high-income settings, particularly in Europe (15/47, 32%), with substantial gaps in Africa (2%) and the Eastern Mediterranean (4%). Variation in inclusivity and methodological rigour was observed, including underrepresentation of adolescents (77%), individuals with lived experience (30%), and gender-diverse people (19%), as well as inconsistent approaches to grading evidence. There was also limited consideration of primary care physicians (49%), who play a key role in early diagnosis and management. Gaps in alignment across guidelines on key diagnostic and therapeutic pathways include recommendations on histological confirmation, biomarker use, aromatase inhibitors, repeat surgery, fertility care, non-medical interventions, and self-care interventions.Conclusions\n\nThese findings highlight the need for a global normative guideline, greater standardisation in guideline development methods, context-specific guidance that incorporates the needs and rights of end-users, and coordinated efforts to strengthen equitable, evidence-based care.",
  "abstract_shown": true,
  "affiliations": [
    "Australian Women and Girls' Health Research Centre, School of Public Health, The University of Queensland, Brisbane, QLD, Australia. d.gete@uq.edu.au.",
    "Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Manitoba, Winnipeg, MB, Canada.",
    "Discipline of Women's Health, School of Clinical Medicine, The University of New South Wales, Sydney, NSW, Australia.",
    "National Endometriosis Clinical and Scientific Trials (NECST) Network, UNSW, Sydney, NSW, Australia.",
    "Australian Women and Girls' Health Research Centre, School of Public Health, The University of Queensland, Brisbane, QLD, Australia.",
    "Oxford Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK.",
    "University of California San Francisco, San Francisco, CA, USA.",
    "Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.",
    "Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.",
    "Department of Obstetrics and Gynaecology, University of Colombo, Colombo, Sri Lanka.",
    "Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA.",
    "Endometriosis Foundation of Kenya, Nairobi, Kenya.",
    "World Endometriosis Organisation, Edinburgh, UK.",
    "Endometriose Stichting, Sittard, The Netherlands.",
    "University of the Philippines Manila College of Medicine, Manila, Philippines.",
    "Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.",
    "Department of Basic Sciences, Ponce Health Sciences University, Ponce, Puerto Rico.",
    "Department of Obstetrics and Gynecology, Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.",
    "Université Paris-Saclay, UVSQ, Inserm, CESP, Villejuif, France.",
    "Department of Obstetrics and Gynaecology, Maastricht University Medical Centre and Grow, research institute for oncology and reproduction, Maastricht, The Netherlands.",
    "Senior Lecturer, Department of Biochemistry, University of Nairobi, Nairobi, Kenya.",
    "Department of Clinical Sciences, Obstetrics and Gynaecology, Umeå University, Umeå, Sweden.",
    "Chair of the Board of Trustees at the Women's Health Foundation, Budapest, Hungary.",
    "University College London, Elizabeth Garrett Anderson Institute for Women's Health and University College London Hospital, Women's Health Division, London, UK.",
    "Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.",
    "Flinders University, Adelaide, SA, Australia.",
    "University of Auckland and Auckland Gynaecology Group, Auckland, New Zealand.",
    "Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.",
    "Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, UK.",
    "Department of Sexual, Reproductive, Maternal, Child, Adolescent Health and Ageing (LHR), World Health Organization, Geneva, Switzerland.",
    "Australian Women and Girls' Health Research Centre, School of Public Health, The University of Queensland, Brisbane, QLD, Australia. g.mishra@uq.edu.au."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 29,
  "authors": [
    {
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        0
      ],
      "name": "Dereje G Gete",
      "orcid": "0000-0003-4819-7685"
    },
    {
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        1
      ],
      "name": "Devon Evans",
      "orcid": "0000-0002-2326-5090"
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    {
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        2,
        3
      ],
      "name": "Jason Abbott"
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    {
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        4
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      "name": "Leticia W Ribeiro"
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    {
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        5
      ],
      "name": "Krina T Zondervan",
      "orcid": "0000-0002-0275-9905"
    },
    {
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        6
      ],
      "name": "Linda C Giudice"
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        7
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      "name": "Luk Rombauts"
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        8
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      "name": "Mathew Leonardi"
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        9
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      "name": "Hemantha Senanayake"
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      "name": "G David Adamson",
      "orcid": "0000-0002-5387-7629"
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        11,
        12
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      "name": "Elsie Wandera"
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        12,
        13
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      "name": "Femke Jansen"
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      "name": "Sally Motlock"
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      "name": "Angela G Sison-Aguilar"
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        15
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      "name": "Sawsan As-Sanie"
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    {
      "affs": [
        16
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      "name": "Idhaliz Flores"
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    {
      "affs": [
        17
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      "name": "Kaori Koga"
    },
    {
      "affs": [
        18
      ],
      "name": "Marina Kvaskoff"
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    {
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        19
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      "name": "Jacques Wm Maas"
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    {
      "affs": [
        20
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      "name": "Ezekiel Onyonka Mecha"
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    {
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        21
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      "name": "Engin Oral"
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    {
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        22
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      "name": "Adrienn Salamon"
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    {
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      "name": "Ertan Saridogan"
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    {
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      "name": "Paul J Yong"
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      "name": "Neil P Johnson"
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    {
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      "name": "Stacey A Missmer"
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    {
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      "name": "Andrew Horne",
      "orcid": "0000-0002-9656-493X"
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    {
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        29
      ],
      "name": "Manjulaa Narasimhan",
      "orcid": "0000-0003-0598-6887"
    },
    {
      "affs": [
        30
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      "name": "Gita D Mishra",
      "orcid": "0000-0001-9610-5904"
    }
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  "bibtex": "https://research.draconitic.com/paper/9v5gby8dyevc2.bib",
  "cited_by": 0,
  "doi": "10.1038/s43856-026-01907-w",
  "fulltext_url": "https://europepmc.org/articles/PMC13669371",
  "id": "9v5gby8dyevc2",
  "issns": [
    "2730-664X"
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  "landing_url": "https://www.nature.com/articles/s43856-026-01907-w",
  "language": "eng",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0",
  "metadata_licence": null,
  "native_subjects": [
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      "2743|Endometriosis Research and Treatment"
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  "pdf_url": "https://www.nature.com/articles/s43856-026-01907-w.pdf",
  "pmcid": "PMC13669371",
  "pmid": "42875470",
  "published": "2026-10-14",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/9v5gby8dyevc2.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:53Z",
      "native_id": "10.1038/s43856-026-01907-w",
      "source": "crossref",
      "url": "https://www.nature.com/articles/s43856-026-01907-w"
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    {
      "first_seen": "2026-10-30T12:18:46Z",
      "native_id": "MED:42875470",
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      "url": "https://europepmc.org/article/MED/42875470"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2743|Endometriosis Research and Treatment",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Global inequities and fragmentation in guidelines for endometriosis: a scoping review",
  "title_text": "Global inequities and fragmentation in guidelines for endometriosis: a scoping review",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:46Z",
  "url": "https://research.draconitic.com/paper/9v5gby8dyevc2",
  "venue": "Communications Medicine",
  "versions": []
}