Hormonresistenz in der medikamentösen Therapie der Endometriose

In: Gynäkologische Endokrinologie · 2020 · vol. 18(4) , pp. 252–257 · doi:10.1007/s10304-020-00346-7 · W3091006938
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This review discusses progesterone resistance in endometriosis, examining its origins, consequences, and interventions with various hormonal therapies.

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This review article examines hormone resistance as a mechanism underlying variable efficacy of medical therapy in endometriosis, focusing on progesterone resistance and related estrogen/progesterone signaling pathways. It synthesizes evidence from the literature describing origins of progesterone resistance, consequences for treatment response, and proposed interventions, including how progesterone receptor status may predict response to progestins and why signaling may fail. A major limitation is that, as a narrative literature synthesis, it does not present new patient data or a uniform systematic method for comparing studies. Relevance to endometriosis: the paper’s central theme is hormone resistance in the pharmacologic treatment of endometriosis, specifically mechanisms such as progesterone signaling dysfunction and therapeutic success versus failure.

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Literatur Patel BG, Rudnicki M, Yu J, Shu Y, Taylor RN (2017) Progesterone resistance in endometriosis: origins, consequences and interventions. Acta Obstet Gynecol Scand 96(6):623–632 Marquardt RM, Kim TH, Shin JH, Jeong JW (2019) Progesterone and estrogen signaling in the endometrium: what goes wrong in endometriosis? IJMS 20(15):3822 Bulun SE (2009) Endometriosis. N Engl J Med 360(3):268–279 Harrison RF, Barry-Kinsella C (2000) Efficacy of medroxyprogesterone treatment in infertile women with endometriosis: a prospective, randomized, placebo-controlled study. Fertil Steril 74(1):24–30 Vercellini P, De Giorgi O, Mosconi P, Stellato G, Vicentini S, Crosignani PG (2002) Cyproterone acetate versus a continuous monophasic oral contraceptive in the treatment of recurrent pelvic pain after conservative surgery for symptomatic endometriosis. 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J Womens Health 28(2):170–177 Strowitzki T, Marr J, Gerlinger C, Faustmann T, Seitz C (2010) Dienogest is as effective as leuprolide acetate in treating the painful symptoms of endometriosis: a 24-week, randomized, multicentre, open-label trial. Hum Reprod 25(3):633–641 Harada T, Kosaka S, Elliesen J, Yasuda M, Ito M, Momoeda M (2017) Ethinylestradiol 20 mug/drospirenone 3 mg in a flexible extended regimen for the management of endometriosis-associated pelvic pain: a randomized controlled trial. Fertil Steril 108(5):798–805 Yamanaka A, Hada T, Matsumoto T et al (2017) Effect of dienogest on pain and ovarian endometrioma occurrence after laparoscopic resection of uterosacral ligaments with deep infiltrating endometriosis. Eur J Obstet Gynecol Reprod Biol 216:51–55 Chen YJ, Hsu TF, Huang BS, Tsai HW, Chang YH, Wang PH (2017) Postoperative maintenance levonorgestrel-releasing intrauterine system and endometrioma recurrence: a randomized controlled study. Am J Obstet Gynecol 216(6):582.e1–582.e9 Cho S, Jung JA, Lee Y et al (2014) Postoperative levonorgestrel-releasing intrauterine system versus oral contraceptives after gonadotropin-releasing hormone agonist treatment for preventing endometrioma recurrence. Acta Obstet Gynecol Scand 93(1):38–44 Morelli M, Sacchinelli A, Venturella R, Mocciaro R, Zullo F (2013) Postoperative administration of dienogest plus estradiol valerate versus levonorgestrel-releasing intrauterine device for prevention of pain relapse and disease recurrence in endometriosis patients. J Obstet Gynaecol Res 39(5):985–990 Carr B, Dmowski WP, O’Brien C et al (2014) Elagolix, an oral GnRH antagonist, versus subcutaneous depot medroxyprogesterone acetate for the treatment of endometriosis: effects on bone mineral density. Reprod Sci 21(11):1341–1351 Flores VA, Vanhie A, Dang T, Taylor HS (2018) Progesterone receptor status predicts response to progestin therapy in endometriosis. J Clin Endocrinol Metab 103(12):4561–4568 Maiorana A, Incandela D, Parazzini F et al (2017) Efficacy of dienogest in improving pain in women with endometriosis: a 12-month single-center experience. Arch Gynecol Obstet 296(3):429–433 Vercellini P, Bracco B, Mosconi P et al (2016) Norethindrone acetate or dienogest for the treatment of symptomatic endometriosis: a before and after study. Fertil Steril 105(3):734–743.e3 Reis FM, Coutinho LM, Vannuccini S, Batteux F, Chapron C, Petraglia F (2020) Progesterone receptor ligands for the treatment of endometriosis: the mechanisms behind therapeutic success and failure. Hum Reprod Update 26(4):565–585 Author information Authors and Affiliations Corresponding author Ethics declarations Interessenkonflikt Q. Le, S. Franik, L. Kiesel und S.D. Schäfer geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Additional information Redaktion A. Bachmann, Frankfurt L. Kiesel, Münster P. Stute, Bern Rights and permissions About this article Cite this article Le, Q., Franik, S., Kiesel, L. et al. Hormonresistenz in der medikamentösen Therapie der Endometriose. Gynäkologische Endokrinologie 18, 252–257 (2020). https://doi.org/10.1007/s10304-020-00346-7 Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s10304-020-00346-7

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