23/05/2026
ENDOMETRIOSIS: ACOG 2026 UPDATE in 60 SECONDS!”
“ACOG has changed the way we diagnose AND treat endometriosis in 2026. Here are the updates every OBG must know!”
**1️⃣ Diagnosis is now CLINICAL FIRST — laparoscopy NOT needed
“2026 update is clear:
👉 If symptoms + exam + imaging fit → treat as endometriosis
👉 Laparoscopy is NOT required to ‘confirm’ diagnosis.”
**2️⃣ Non-invasive Diagnostics Upgraded
“ACOG endorses:
✔️ Transvaginal US (first-line)
✔️ MRI for DIE mapping
✔️ Biomarkers: CA-125 is NOT a diagnostic test
✔️ ‘Endometriosis symptom score’ added for tracking response.”
**3️⃣ First-line Treatment SHIFT
“Medical therapy BEFORE surgery unless red flags.
First-line meds:
✔️ Combined OCPs
✔️ Progestins (Dienogest strongest evidence 2026)
✔️ LNG-IUS
✔️ GnRH antagonists (Elagolix/Relugolix) early use allowed.”
**4️⃣ Surgery — Narrower Indications
“Surgery now recommended ONLY for:
🔸 Endometriomas > 4–5 cm causing pain/infertility
🔸 DIE causing bowel/ureteric compromise
🔸 Failure of optimal medical therapy
🔸 Infertility needing access for ART”
**5️⃣ Infertility Management Streamlined
“If endometriosis + infertility:
➡️ Treat pain medically
➡️ Do NOT delay ART
➡️ Surgery only if required for access, not routinely.”
**6️⃣ Adolescents Update
“ACOG emphasises early recognition:
✔️ Treat clinically
✔️ Avoid repeated laparoscopies
✔️ Use progestins + LNG-IUS as first-line.”
“Endometriosis is now a clinical diagnosis, with medical therapy FIRST. Update your practice — ACOG 2026 changes everything!”
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