Advances in the management of endometriosis

An update for clinicians

PierGiorgio Crosignani, David Olive, Agneta Bergqvist, Anthony Luciano

Research output: Contribution to journalArticle

184 Citations (Scopus)

Abstract

Endometriosis is a chronic and recurrent disease characterized by the presence and proliferation of endometrial tissue outside the uterine cavity, which occurs in approximately 10% of women of reproductive age. In this estrogen-dependent disorder, lesions become inactive and gradually undergo regression during states of ovarian down-regulation, such as amenorrhoea or menopause. The impact of endometriosis includes impaired fertility potential, as well as symptoms of dysmenorrhoea, dyspareunia and chronic non-menstrual pain, all of which adversely affect quality of life. Management of endometriosis focuses on pain relief and includes medical and surgical treatment. Pharmacologic therapies currently in use include combination oral contraceptives (COCs), danazol, GnRH analogues and progestins. Although some agents show efficacy in relieving pain, all differ in their side effects, making it difficult to achieve a balance between efficacy and safety. Efficacy has been demonstrated with danazol or GnRH analogues; however, treatment is limited to 6 months because of significant metabolic side effects. Alternatives for longer-term management of symptoms include add-back therapy with GnRH analogues, COCs or progestins. Newer options for treatment of endometriosis include depot medroxyprogesterone acetate subcutaneous injection, as well as several agents under investigation that may prove to have therapeutic potential.

Original languageEnglish
Pages (from-to)179-189
Number of pages11
JournalHuman Reproduction Update
Volume12
Issue number2
DOIs
Publication statusPublished - Mar 2006

Fingerprint

Endometriosis
Gonadotropin-Releasing Hormone
Danazol
Oral Contraceptives
Pain
Therapeutics
Progesterone Congeners
Dyspareunia
Dysmenorrhea
Medroxyprogesterone Acetate
Amenorrhea
Progestins
Subcutaneous Injections
Menopause
Fertility
Estrogens
Chronic Disease
Down-Regulation
Quality of Life
Safety

Keywords

  • Androgens
  • Endometriosis
  • GnRH (AG/ANTAG)
  • Progesterone
  • Surgery

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

Cite this

Advances in the management of endometriosis : An update for clinicians. / Crosignani, PierGiorgio; Olive, David; Bergqvist, Agneta; Luciano, Anthony.

In: Human Reproduction Update, Vol. 12, No. 2, 03.2006, p. 179-189.

Research output: Contribution to journalArticle

Crosignani, P, Olive, D, Bergqvist, A & Luciano, A 2006, 'Advances in the management of endometriosis: An update for clinicians', Human Reproduction Update, vol. 12, no. 2, pp. 179-189. https://doi.org/10.1093/humupd/dmi049
Crosignani, PierGiorgio ; Olive, David ; Bergqvist, Agneta ; Luciano, Anthony. / Advances in the management of endometriosis : An update for clinicians. In: Human Reproduction Update. 2006 ; Vol. 12, No. 2. pp. 179-189.
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