Dysmenorrhea is the most symptoms in women with endometriosis; its intensity is often severe and causes a significant decrease in quality of life. It is often associated with other pain symptoms (such as deep dyspareunia, dyschezia, non-menstrual pelvic pain). The pathogenesis of dysmenorrhea in women with endometriosis remains uncertain; it may be due to nociceptive, inflammatory and neuropathic mechanisms. Two types of therapy for endometriosis-related dysmenorrhea are available: pharmacological therapies that inhibit the growth of the endometriotic implants and surgical therapies, which aim to remove the endometriotic implants. Various hormonal treatments have been shown to effectively and safely relieve pain: non-steroidal anti-inflammatory drugs, progestins, androgens, combined oral contraceptive pill, gonadotropin releasing hormones analogues, gonadotropin releasing hormones antagonists and aromatase inhibitors. Hormonal therapies do not cure endometriosis, therefore patients require a long-term treatment. All hormonal therapies are contraceptive and, therefore, they cannot be administered to patients desiring to conceive. Given this background, the choice of the drug should be based on the preference of the patients, on the incidence of adverse effects and on costs. Surgical excision of endometriosis is a valuable option in patients with severe dysmenorrhea desiring to conceive, in those who have persistence of the symptom despite the administration of hormonal therapies and in those who have contraindications to the use of hormonal therapies. However, dysmenorrhea may recur after surgery if patients do not receive a postoperative hormonal therapy.
|Title of host publication||Menorrhagia and Dysmenorrhea: Risk Factors, Diagnosis and Management|
|Publisher||Nova Science Publishers, Inc.|
|Number of pages||23|
|ISBN (Print)||9781634825832, 9781634825528|
|Publication status||Published - Apr 1 2015|
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