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

Fingerprint

Endometriosis
Progestins
Gestrinone
Ovulation Inhibition
Contraceptives, Oral, Combined
Danazol
Therapeutics
Oral Contraceptives
Gonadotropin-Releasing Hormone
Pharmaceutical Preparations
Chronic Disease
Pharmacology
Safety
Costs and Cost Analysis
Pain
Pregnancy

Keywords

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

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Endometriosis : current and future medical therapies. / Vercellini, Paolo; Somigliana, Edgardo; Viganò, Paola; Abbiati, Annalisa; Daguati, Raffaella; Crosignani, Pier Giorgio.

In: Best Practice and Research: Clinical Obstetrics and Gynaecology, Vol. 22, No. 2, 04.2008, p. 275-306.

Research output: Contribution to journalArticle

Vercellini, Paolo ; Somigliana, Edgardo ; Viganò, Paola ; Abbiati, Annalisa ; Daguati, Raffaella ; Crosignani, Pier Giorgio. / Endometriosis : current and future medical therapies. In: Best Practice and Research: Clinical Obstetrics and Gynaecology. 2008 ; Vol. 22, No. 2. pp. 275-306.
@article{8f6c71d241fd42fa9f818580733f0f1d,
title = "Endometriosis: current and future medical therapies",
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.",
keywords = "danazol, endometriosis, gestrinone, GnRH analogues, oral contraceptives, pelvic pain, progestins",
author = "Paolo Vercellini and Edgardo Somigliana and Paola Vigan{\`o} and Annalisa Abbiati and Raffaella Daguati and Crosignani, {Pier Giorgio}",
year = "2008",
month = "4",
doi = "10.1016/j.bpobgyn.2007.10.001",
language = "English",
volume = "22",
pages = "275--306",
journal = "Best Practice and Research in Clinical Obstetrics and Gynaecology",
issn = "1521-6934",
publisher = "Bailliere Tindall Ltd",
number = "2",

}

TY - JOUR

T1 - Endometriosis

T2 - current and future medical therapies

AU - Vercellini, Paolo

AU - Somigliana, Edgardo

AU - Viganò, Paola

AU - Abbiati, Annalisa

AU - Daguati, Raffaella

AU - Crosignani, Pier Giorgio

PY - 2008/4

Y1 - 2008/4

N2 - 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.

AB - 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.

KW - danazol

KW - endometriosis

KW - gestrinone

KW - GnRH analogues

KW - oral contraceptives

KW - pelvic pain

KW - progestins

UR - http://www.scopus.com/inward/record.url?scp=39749127802&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=39749127802&partnerID=8YFLogxK

U2 - 10.1016/j.bpobgyn.2007.10.001

DO - 10.1016/j.bpobgyn.2007.10.001

M3 - Article

C2 - 18036995

AN - SCOPUS:39749127802

VL - 22

SP - 275

EP - 306

JO - Best Practice and Research in Clinical Obstetrics and Gynaecology

JF - Best Practice and Research in Clinical Obstetrics and Gynaecology

SN - 1521-6934

IS - 2

ER -