Pharmacological treatment of endometriosis: review of current and new options for treatment

  • Maja Jakič Medicinska fakulteta, Ljubljana
  • Andrej Vogler Ginekološka klinika, Univerzitetni klinični center Ljubljana
  • Tea Lanišnik Rižner Institute of Biochemistry Faculty of Medicine University of Ljubljana
Keywords: pharmacological treatment, anti-inflammatory agents, hormone therapy, anti-angiogenic agents, antioxidants, histone deacetylase inhibitors.

Abstract

Endometriosis is a gynecological disease that is defined as the presence of endometrium-like tissue outside the uterine cavity, and it is one of the main causes of female infertility. Although there is unfortunately no known ‘optimal’ treatment for endometriosis, there are three treatment options: medication, surgical treatment, and a combination of both. The gold standard for diagnosis of endometriosis is a diagnostic laparoscopy, which is also therapeutic. Indications for pharmacological treatment of endometriosis include empirical treatment for patients with pelvic pain who are normal on gynecological examination, or who have recurrent disease after surgical treatment or in combination with surgical treatment. In everyday practice, non-steroid anti-inflammatory drugs, oral contraceptives, and progestins per os are used as first-line pharmacological treatments of endometriosis. Gonadoliberin agonists can be used as second-line treatment, although their use is discouraged. These medications can be used alone or in combination. Studies over the last 10 years have shown that many other agents have potential for treatment of endometriosis. These can be broadly classified into several groups: anti-inflammatory agents, and agents that interfere with the hormonal system, or with other pathophysiological processes, such as a disturbed immune system, reduced apoptosis, enhanced angiogenesis, degradation of the extracellular matrix, increased oxidative stress, and epigenetic changes. However, their introduction into routine use requires more convincing clinical studies to confirm their effectiveness.

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Published
2016-08-29
How to Cite
1.
Jakič M, Vogler A, Lanišnik Rižner T. Pharmacological treatment of endometriosis: review of current and new options for treatment. TEST ZdravVestn [Internet]. 29Aug.2016 [cited 29Mar.2024];85(7-8). Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/1416