Screening and management of endometriosis by primary care physicians

Objective. - Analyze knowledge and practices of general practitioners concerning the screening and treatment of endometriosis in primary care. Methods. - Observational study carried out with general practitioners in a healthcare area using an anonymous online questionnaire about symptoms, screening and their management of endometriosis. Responses were analyzed according to the general practitioners' sex, age and practice in gynecology. Results. - Sixty-nine general practitioners (69/458 ; 15.1%) responded. Women (18.4% vs. 9.7% : P = 0.02), between 40 and 59 years old (26.5% vs. 0 ; P < 0.01), with additional training in gynecology (27.2% vs. 3.0%; P < 0.01) had significant activity in gynecology. Typical symptoms of endometriosis were experienced by 76.8% general practitioners, but only 36% "often" or "always" referred to endometriosis when faced with these symptoms. Additional training in gynecology, mostly carried out by women, between 40 and 59 years old, had a positive impact on the evocation of endometriosis in the face of these symptoms. If endometriosis was suspected, 72.5% GPs immediately ordered pelvic ultrasound and 85.5% for analgesics, but 42% referred the woman to a gynecologist. Conclusion. - The general practitioner has a key role in the screening and initial management of endometriosis in primary care. The practice and continuing education of general practitioners in gynecology has a significant impact in improving the screening and initial management of endometriosis. (C) 2021 Elsevier Masson SAS. All rights reserved.