![]() ![]() ![]() 5, 9 – 11 GnRH agonists, with and without add-back therapy, are effective in the relief of endometriosis-associated pain, but can be associated with severe side effects. 6 – 8 Progestogens (medroxyprogesterone acetate, oral or depot, dienogest, cyproterone acetate, norethisterone acetate, danazol, levonorgestrel intrauterine device) and anti-progestogens (gestrinone) are also recommended to reduce endometriosis-associated pain. Hormonal contraceptives reduce pain associated to endometriosis, by oral, transdermal, or vaginal administration. 3 Hormonal drugs currently used for the treatment of pain associated to endometriosis are hormonal contraceptives, progestogens and anti-progestogens, gonadotropin releasing hormone (GnRH) agonists and antagonists, and aromatase inhibitors. Hormonally active drugs act by blocking the ovarian function and creating a more stable hormonal environment. 3 Nonsteroidal anti-inflammatory drugs (NSAIDs) are used commonly in women with dysmenorrhea, although there is not enough evidence to admit that they are effective in the treatment of endometriosis related pain, and there is lack of evidence to recommend one NSAID among the others. 2 Long-term medical treatment is needed in most women unfortunately in most women, pain symptoms recur between 6 months and 12 months once treatment is stopped.Ĭurrent medical treatments are based on two mechanisms of action: anti-inflammatory and hormonal. This can be achieved surgically or medically, although in most women a combination of both is required. The main purpose of endometriosis management is alleviating pain associated to the disease. It affects between 6% and 10% of women in reproductive age and causes a broad spectrum of pain symptoms ranging from no symptoms to severe dysmenorrhea, dyspareunia, dyschezia, chronic pelvic pain, and infertility. Upcoming researches and controlled clinical trials should focus on these drugs.Įndometriosis is an inflammatory estrogen-dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. For this purpose, antiangiogenic factors could be important components of endometriosis therapy in the future. There is a need to find effective treatments that do not block the ovarian function. GnRH antagonists are expected to be as effective as GnRH agonists, but with easier administration (oral). Among new hormonal drugs, association to aromatase inhibitors could be effective in the treatment of women who do not respond to conventional therapies. ![]() Hormonal treatments currently available are effective in the relief of pain associated to endometriosis. Keywords included “endometriosis” matched with “medical treatment”, “new treatment”, “GnRH antagonists”, “Aromatase inhibitors”, “selective progesterone receptor modulators”, “anti-TNF α”, and “anti-angiogenic factors”. The authors conducted a literature search for English original articles, related to new medical treatments of endometriosis in humans, including articles published in PubMed, Medline, and the Cochrane Library. Unfortunately, in most cases, pain symptoms recur between 6 months and 12 months once treatment is stopped. Long-term medical treatment is usually needed in most women. This can be achieved surgically or medically, although in most women a combination of both treatments is required. Endometriosis is an inflammatory estrogen-dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. ![]()
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