{"paper_id":"376dbaa3-e074-4502-b5a5-fceb9751ccfa","body_text":"Zusammenfassung\nDie medikamentöse Therapie der Endometriose verfolgt einen symptomatischen Ansatz, ist nicht kausal und kann die natürliche Fertilität nicht beeinflussen. Die Durchführung einer hormonellen medikamentösen Therapie verhindert das gleichzeitige Erfüllen eines Kinderwunsches. Bei einer Therapiedauer von 6 Monaten sind die hormonellen Therapieoptionen bezüglich der Schmerzreduktion gleichwertig. Die Auswahl der Behandlungsform und der Dauer sollten symptomorientiert erfolgen, nicht in Abhängigkeit von der Ausdehnung der Erkrankung. Aufgrund des Nebenwirkungsprofils ist als First-line-Therapie orale Kontrazeptiva (OC)oder Gestagenen zu empfehlen, GnrH-Analoga in der Second-line-Therapie. Bei fehlendem Kinderwunsch kann mit C und Gestagenen ggf. auch eine Dauertherapie unter Beachtung des Nebenwirkungsprofils erfolgen. Am besten sollten OC und Gestagene im Langzyklus eingesetzt werden. Dabei kann eine gute Wirkung insbesondere auf die Dysmenorrhö, allerdings nur eine mäßige Wirkung auf andere typische Beschwerden erwartet werden. GnRH-Analoga sollten im Add-back-Verfahren eingesetzt werden und sind eine sinnvolle Alternative nach histologischer Sicherung der Erkrankung und bei fehlender Wirksamkeit von OC und Gestagenen. Ist eine assistierte Reproduktion geplant, sollte ggf. das Ultralangprotokoll mit GnRH-Analoga-Stimulation erwogen werden. Andere Substanzklassen sind spezifischen Indikationen vorbehalten und haben keinen Stellenwert in der Routinetherapie.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nPreview\nUnable to display preview. 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Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44424-5_10\nDownload citation\nDOI: https://doi.org/10.1007/978-3-662-44424-5_10\nPublished:\nPublisher Name: Springer, Berlin, Heidelberg\nPrint ISBN: 978-3-662-44423-8\nOnline ISBN: 978-3-662-44424-5\neBook Packages: Medicine (German Language)","source_license":"CC0","license_restricted":false}