Clinical Management of Endometriosis

Tommaso Falcone, Dan I Lebovic
Obstetrics and gynecology · 2011 · vol. 118(3) , pp. 691–705 · doi:10.1097/aog.0b013e31822adfd1 · PMID:21860303 · W2332643287
article OA: closed CC0 ⤵ 202 in-corpus citations
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This article reviews surgical and medical management strategies for endometriosis, addressing diagnosis, infertility, chronic pain, cancer risk, and postmenopausal hormone therapy.

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Abstract

Endometriosis is a common and challenging condition of reproductive-aged women that carries a high individual and societal cost. The many molecular dissimilarities between endometriosis lesions and eutopic endometrium create difficulties in the development of new drug therapies and treatments. Surgery remains the gold standard for definitive diagnosis, but it must be weighed against the risks of surgical morbidity and potential decreases in ovarian reserve, especially in the case of endometriomas. Safe and effective surgical techniques are discussed within this article for various presentations of endometriosis. Medical therapy is suppressive rather than curative, and regimens that are long-term and affordable with minimal side effects are recommended. Recurrences are common and often rapid when medical therapy is discontinued. Endometriosis in the setting of infertility is reviewed and appropriate management is discussed, including when and whether surgery is warranted in this at-risk population. In patients with chronic pain, central sensitization and myofascial pain are integral components of a multidisciplinary approach. Endometriosis is associated with an increased risk of epithelial ovarian cancer; however, the risk is low and currently no preventive screening is recommended. Hormone therapy for symptomatic women with postsurgical menopause should not be delayed as a result of concerns for malignancy or recurrence of endometriosis.

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Condition tags

endometriosischronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Adult Drug Therapy, Combination Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Female Fertilization in Vitro Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Infertility, Female Infertility, Female Laparoscopy Pelvic Pain Pelvic Pain Pelvic Pain

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 (50)

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License: CC0 · commercial use OK