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Endometriosis is an oestrogen-dependent chronic condition associated with serious morbidity in a few sufferers. It affects up to 10% of women of reproductive age. Up to 30% of sub-fertile women have endometriosis. Common symptoms are worsening dysmenorrhoea and dyspareunia. Rarer symptoms include pain during defaecation and cyclical PR bleeding, which may be seen in women with deeply infiltrating endometriosis (DIE) in the rectovaginal septum, and this is often mistaken for irritable bowel syndrome. Laparoscopy remains the gold standard diagnostic investigation. The aim of treatment is to control symptoms and prevent recurrence. Pelvic pain can be treated without a definitive diagnosis using a therapeutic trial of analgesics and hormones if there are no current fertility issues. Surgical treatment is now based on excision as opposed to diathermy ablation. Medical treatment should be for at least 6 months if the combined pill or GnRH agonists are used. Newer therapies using aromatase inhibitors are being trialled. Complex cases require a multidisciplinary approach. [ABSTRACT FROM AUTHOR]