Role of hormonal therapies in endometriosis: balancing efficacy and safety

Ferrero S, Simone Ferrero, Michele Paudice, Paudice M, Umberto Perrone, Perrone U, Rosato FP, Francesco Paolo Rosato, Gullo G, Giuseppe Gullo, Vellone VG, Valerio Gaetano Vellone, Barra F, Fabio Barra
Expert opinion on pharmacotherapy · 2026 · vol. 27(9) , pp. 757–772 · doi:10.1080/14656566.2026.2685064 · PMID:42268585 · W7164159747
review OA: bronze
📄 Open PDF View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-13 ⓘ

This review examines the effectiveness and side effects of various hormonal treatments used for endometriosis management.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

INTRODUCTION: Endometriosis is a chronic, estrogen-dependent inflammatory disorder requiring long-term management strategies that balance efficacy with systemic safety. Although hormonal therapies remain the cornerstone of treatment, the optimal degree of estrogen suppression needed to achieve durable symptom control while minimizing adverse effects remains controversial. AREAS COVERED: This narrative review, based on a targeted PubMed/MEDLINE literature search and review of major guideline documents published up to January 2026, critically evaluates the efficacy, mechanisms of action, and safety profiles of combined oral contraceptives, progestins, GnRH agonists, and oral GnRH antagonists within an estrogen-threshold modulation framework. EXPERT OPINION: Combined oral contraceptives and progestins remain preferred first-line therapies because they provide effective pain control with acceptable tolerability and preservation of bone health. GnRH agonists and oral GnRH antagonists offer more profound endocrine suppression and are particularly useful in women with moderate-to-severe pain or inadequate response to first-line treatment, although their use is limited by hypoestrogenic adverse effects. Increasing evidence suggests that maximal estrogen suppression is not universally necessary to achieve clinical benefit and may expose patients to unnecessary long-term toxicity. Future management will likely move toward individualized estrogen-threshold modulation integrated with multimodal pain management and biomarker-driven approaches.

My notes (saved in your browser only)

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (100)

Cited by (2)

SciLite annotations

chemicals 5
estrogen progestin estrogen progestin estrogen

Source provenance

europepmc
last seen: 2026-09-09T06:15:24.302764+00:00
openalex
last seen: 2026-09-09T06:06:51.992953+00:00
pubmed
last seen: 2026-09-09T06:09:09.680287+00:00
scilite
last seen: 2026-06-21T06:47:03.627287+00:00
unpaywall
last seen: 2026-09-09T06:31:01.691765+00:00