Endometriosis: current and future medical therapies

Paolo Vercellini, Edgardo Somigliana, Paola Viganò, Annalisa Abbiati, Raffaella Daguati, Pier Giorgio Crosignani

Research output: Contribution to journalArticle

Abstract

Endometriosis is a chronic inflammatory disease that responds to steroidal manipulation. Creation of a steady hormonal environment with inhibition of ovulation temporarily suppresses the ectopic implants and reduces the inflammatory status as well as the associated pain symptoms. Pharmacological management of endometriosis must be set within the framework of long-term therapeutic strategies. As the available drugs are not curative, treatments will need to be administered for years or until women desire a pregnancy. The various therapies studied have shown similar efficacy. Consequently, based on a more favourable profile in terms of safety, tolerability and cost, combined oral contraceptives and progestins should be considered as the first-line option, both as an alternative to surgery and as a postoperative adjuvant measure. Gonadotrophin-releasing hormone analogues, danazol and gestrinone should be used when progestins and oral contraceptives fail, are not tolerated or are contra-indicated. Future therapies for endometriosis must compare favourably with existing drugs before hypothesizing their implementation in current practice. Medical treatment is not indicated in women seeking conception because reproductive prognosis is not ameliorated.

Original languageEnglish
Pages (from-to)275-306
Number of pages32
JournalBest Practice and Research: Clinical Obstetrics and Gynaecology
Volume22
Issue number2
DOIs
Publication statusPublished - Apr 2008

Keywords

  • danazol
  • endometriosis
  • gestrinone
  • GnRH analogues
  • oral contraceptives
  • pelvic pain
  • progestins

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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