Postoperative Medical Therapy After Surgical Treatment of Endometriosis: From Adjuvant Therapy to Tertiary Prevention

Research output: Contribution to journalArticle

Abstract

The high rate of disease recurrence after surgery is critical and frustrating for women with endometriosis. Adjuvant treatments using a 3- to 6-months course of hormone therapy after surgery have been extensively investigated during the last 2 decades; however, results have been unsatisfactory, primarily because the benefits of hormone therapy rapidly vanish once treatment is discontinued. The protective effect is limited to the period of use. Accordingly, it is recognized that suppressive hormone therapy after surgery markedly prevents recurrent episodes only if given over the long term. The emerging view is that estroprogestins do not ameliorate the effects of surgery but demonstrate tertiary prevention of the disease. They prevent ovulation and reduce retrograde menstrual flow, two crucial events in the pathogenesis of endometriosis. The available literature strongly supports the benefits of prolonged administration of estroprogestins after surgery in preventing recurrence of endometriomas and dysmenorrhea. In contrast, data on dyspareunia and nonmenstrual pelvic pain remain scanty and unconvincing, and there is no information about recurrence of other forms of endometriosis such as peritoneal implants and adhesions. Overall, estroprogestin therapy after surgery to treat endometriosis should be recommended in women who do not seek to become pregnant. Further evidence is warranted to better delineate the beneficial effects of this emerging but convincing strategy.

Original languageEnglish
Pages (from-to)328-334
Number of pages7
JournalJournal of Minimally Invasive Gynecology
Volume21
Issue number3
DOIs
Publication statusPublished - 2014

Keywords

  • Endometriosis
  • Estroprogestin
  • Recurrence

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Medicine(all)

Fingerprint Dive into the research topics of 'Postoperative Medical Therapy After Surgical Treatment of Endometriosis: From Adjuvant Therapy to Tertiary Prevention'. Together they form a unique fingerprint.

  • Cite this