{"paper_id":"9bbf93dd-1a27-485f-ac91-9fce17aad42b","body_text":"Tratamento farmacológico contemporâneo para endometriose: uma revisão baseada em evidências clínicas\nDOI:\nhttps://doi.org/10.55905/revconv.19n.3-008Palavras-chave:\nendometriose, GnRH, progestágenos, inibidores da aromatase, anticoncepcionais orais combinadosResumo\nA endometriose, caracterizada pelo crescimento de tecido semelhante ao endométrio fora do útero, afeta cerca de 10% das mulheres em idade reprodutiva e está associada à dor pélvica crônica e infertilidade. Este estudo tem como objetivo avaliar a eficácia, segurança e tolerabilidade dos tratamentos farmacológicos atuais para a endometriose, por meio de uma revisão integrativa da literatura abrangendo estudos de setembro de 2003 a agosto de 2024. As principais opções terapêuticas incluem contraceptivos orais combinados, agonistas e antagonistas de GnRH, progestágenos e inibidores da aromatase. Os resultados indicam que a resposta ao tratamento varia entre as pacientes, com algumas opções apresentando redução significativa dos sintomas, enquanto outras estão associadas a efeitos adversos. O estudo destaca a necessidade de abordagens mais personalizadas e inovadoras, com foco em melhorar a qualidade de vida das pacientes. Conclui-se que, apesar dos avanços, ainda há lacunas significativas no manejo da endometriose, exigindo novas estratégias terapêuticas.\nReferências\nAGARWAL, S. K. et al. Clinical diagnosis of endometriosis: a call to action. American Journal of Obstetrics and Gynecology, v. 220, n. 4, p. 354–354, 2019. DOI: https://doi.org/10.1016/j.ajog.2018.12.039.\nALONSO, A. et al. Medical management of endometriosis. Current Opinion in Obstetrics & Gynecology, v. 36, n. 5, p. 353–361, 2024. DOI: https://doi.org/10.1097/GCO.0000000000000983.\nBARANOV, V.; MALYSHEVA, O.; YARMOLINSKAYA, M. Pathogenomics of endometriosis development. International Journal of Molecular Sciences, v. 19, n. 7, p. 1852, 2018. DOI: https://doi.org/10.3390/ijms19071852.\nBULUN, S. E. et al. Endometriosis. Endocrine Reviews, v. 40, n. 4, p. 1048–1079, 2019. DOI: https://doi.org/10.1210/er.2018-00242.\nCAPOBIANCO, A.; ROVERE-QUERINI, P. Endometriosis, a disease of the macrophage. Frontiers in Immunology, v. 4, p. 9, 2013. DOI: https://doi.org/10.3389/fimmu.2013.00009.\nCARVALHO, N. et al. Control of endometriosis-associated pain with etonogestrel-releasing contraceptive implant and 52-mg levonorgestrel-releasing intrauterine system: randomized clinical trial. Fertility and Sterility, v. 110, n. 6, p. 1129–1136, 2018. DOI: https://doi.org/10.1016/j.fertnstert.2018.07.003.\nCHAUHAN, S. et al. Endometriosis: a review of clinical diagnosis, treatment, and pathogenesis. Cureus, v. 14, n. 9, e28864, 2022. DOI: https://doi.org/10.7759/cureus.28864.\nCOSTA, J. E. F. R. et al. Abdominal wall endometriosis: experience of the general surgery service of the Antônio Pedro University Hospital of the Universidade Federal Fluminense. Revista do Colégio Brasileiro de Cirurgiões, v. 47, e20202544, 2020. DOI: https://doi.org/10.1590/0100-6991e-20202544.\nFALCONE, T.; FLYCKT, R. Clinical management of endometriosis. Obstetrics & Gynecology, v. 131, n. 3, p. 557–571, 2018. DOI: https://doi.org/10.1097/AOG.0000000000002469.\nFERRERO, S.; EVANGELISTI, G.; BARRA, F. Current and emerging treatment options for endometriosis. Expert Opinion on Pharmacotherapy, v. 19, n. 10, p. 1109–1125, 2018. DOI: https://doi.org/10.1080/14656566.2018.1494154.\nGIUDICE, L. C. Endometriosis. The New England Journal of Medicine, v. 362, n. 25, p. 2389–2398, 2010. DOI: https://doi.org/10.1056/NEJMcp1000274.\nINDRACCOLO, U.; INDRACCOLO, S. R.; MIGNINI, F. Micronized palmitoylethanolamide/trans-polydatin treatment of endometriosis-related pain: a meta-analysis. Annali dell’Istituto Superiore di Sanità, v. 53, n. 2, p. 125–134, 2017. DOI: https://doi.org/10.4415/ANN_17_02_08.\nKALAITZOPOULOS, D. R. et al. Treatment of endometriosis: a review with comparison of 8 guidelines. BMC Women’s Health, v. 21, n. 1, p. 397, 2021. DOI: https://doi.org/10.1186/s12905-021-01545-5.\nKIM, H. H. Y. et al. Long-term efficacy and safety of levonorgestrel-releasing intrauterine system as a maintenance treatment for endometriosis. Medicine, v. 101, n. 10, e29023, 2022. DOI: https://doi.org/10.1097/MD.0000000000029023.\nLAGANÀ, A. S. et al. The pathogenesis of endometriosis: molecular and cell biology insights. International Journal of Molecular Sciences, v. 20, n. 22, p. 5615, 2019. DOI: https://doi.org/10.3390/ijms20225615.\nLEYLAND, N. et al. A clinician’s guide to the treatment of endometriosis with Elagolix. Journal of Women’s Health, v. 30, n. 4, p. 569–578, 2021. DOI: https://doi.org/10.1089/jwh.2019.8096.\nLI, Y. et al. Melatonin in endometriosis: mechanistic understanding and clinical insight. Nutrients, v. 14, n. 19, p. 4087, 2022. DOI: https://doi.org/10.3390/nu14194087.\nMITCHELL, J.-B.; CHETTY, S.; KATHRADA, F. Progestins in the symptomatic management of endometriosis: a meta-analysis on their effectiveness and safety. BMC Women’s Health, v. 22, n. 1, p. 526, 2022. DOI: https://doi.org/10.1186/s12905-022-02122-0.\nPARK, S. Y. et al. Efficacy and safety of dienogest in patients with endometriosis: a single-center observational study over 12 months. Clinical and Experimental Reproductive Medicine, v. 43, n. 4, p. 215–220, 2016. DOI: https://doi.org/10.5653/cerm.2016.43.4.215.\nROSA E SILVA, J. C. et al. Endometriose: aspectos clínicos do diagnóstico ao tratamento. Femina, v. 49, n. 3, p. 134–141, 2021. Disponível em: (link informado no seu texto). Acesso em: 23 set. 2024.\nSHAFRIR, A. L. et al. Risk for and consequences of endometriosis: a critical epidemiologic review. Best Practice & Research Clinical Obstetrics & Gynaecology, v. 51, p. 1–15, 2018. DOI: https://doi.org/10.1016/j.bpobgyn.2018.06.001.\nSINCLAIR, J. et al. Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms. PLOS ONE, v. 16, n. 10, e0258940, 2021. DOI: https://doi.org/10.1371/journal.pone.0258940.\nSŁOPIEŃ, R.; MĘCZEKALSKI, B. Aromatase inhibitors in the treatment of endometriosis. Menopausal Review, v. 15, n. 1, p. 43–47, 2016. DOI: https://doi.org/10.5114/pm.2016.58773.\nSOURIAL, S.; TEMPEST, N.; HAPANGAMA, D. K. Theories on the pathogenesis of endometriosis. International Journal of Reproductive Medicine, v. 2014, p. 1–9, 2014. DOI: https://doi.org/10.1155/2014/179515.\nTAKEUCHI, M.; MATSUZAKI, K.; HARADA, M. Endometriosis, a common but enigmatic disease with many faces: current concept of pathophysiology, and diagnostic strategy. Japanese Journal of Radiology, v. 42, n. 8, p. 801–819, 2024. DOI: https://doi.org/10.1007/s11604-024-01569-5.\nVERCELLINI, P. et al. Continuous use of an oral contraceptive for endometriosis-associated recurrent dysmenorrhea that does not respond to a cyclic pill regimen. Fertility and Sterility, v. 80, n. 3, p. 560–563, 2003. DOI: https://doi.org/10.1016/S0015-0282(03)00794-5.\nZONDERVAN, K. T.; BECKER, C. M.; MISSMER, S. A. Endometriosis. The New England Journal of Medicine, v. 382, n. 13, p. 1244–1256, 2020. DOI: https://doi.org/10.1056/NEJMra1810764.\nDownloads\nPublicado\nComo Citar\nEdição\nSeção\nLicença\nCopyright (c) 2026 CONTRIBUCIONES A LAS CIENCIAS SOCIALES\nEste trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial 4.0 International License.","source_license":"CC0","license_restricted":false}