Terapia hormonal na endometriose.

Endometriosis is a disease that affects millions of women around the world. One of the most widely accepted and widespread hypotheses is the hypothesis of retrograde menstruation, in which blood through a flow mechanism can reach the peritoneal cavity, forming ectopic endometrial foci, that is, outside the uterine cavity. Pharmacological and non-pharmacological therapies were elaborated in order to improve the quality of life. As non-pharmacological therapies can be cited: adequate diet, moderate physical activity, integrative therapies and surgical therapy. Pharmacotherapeutic therapy includes the use of phytotherapics, non-hormonal pharmacological therapy and hormonal pharmacological therapy, the focus of this monograph. The objective of this monograph was to find and describe the hormonal therapies available for clinical use in the treatment of Endometriosis. As a methodology, inclusion, exclusion and cross-referencing criteria were used. In combination with hormone therapy in endometriosis, the use of combined oral contraceptives, progestins, agonists and antagonists of gonadotropin releasing hormone and therapy were found. Among the hormonal therapies presented, the most cost-effective treatment duration, efficacy, tolerability, and management of adverse effects due to the available dosage forms were the progestins. As for the analogues of GnRH, they present the limitation of their use for six months due to the adverse effects presented. For GnRH agonists, one way to bypass adverse effects would be to use in combination with low-dose hormonal drugs, called add-back therapy, in order to prolong treatment. The combined oral contraceptive also has a good safety profile, longer treatment time, but its efficacy is more related to the treatment of primary dysmenorrhea. As future perspectives, studies have been carried out relating the use of selective modulators of progesterone and estrogen receptors for the treatment of endometriosis, in addition to the use of aromatase inhibitors. There are also studies trying to find new biomarkers for early and less invasive diagnosis of endometriosis. In conclusion, the present study shows that progestins were shown to have a better benefit-risk among available therapies