The Treatment of Endometriosis

David L. Olive, Olive DL, Elizabeth A. Pritts, Pritts EA
Annals of the New York Academy of Sciences · 2002 · vol. 955(1) , pp. 360–372 · doi:10.1111/j.1749-6632.2002.tb02797.x · PMID:11949962 · W1994733964
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Medical and surgical therapies effectively manage endometriosis pain, while surgical treatment and assisted reproduction improve fertility, though optimal treatment combinations require further research.

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Abstract

The treatment of endometriosis focuses upon amelioration of two symptoms: pain and infertility. The treatment of endometriosis-associated pain has been well studied and all major medical therapies appear to be superior to placebo. In addition, none seems to be drastically better than another. Surgical therapy also appears to be efficacious, albeit with a relatively high rate of recurrence of symptoms following conservative surgical intervention. There are no trials comparing the relative value of medical versus surgical therapy. Combination surgery/medical therapy has several high-quality trials for evaluation, but its value remains unclear. The treatment of endometriosis-associated infertility presents a different picture: medical therapy has not been shown to be of any value and may prove detrimental to fertility. Surgical treatment does improve fertility, probably for all stages of disease. Assisted reproduction also seems to be efficacious, with both controlled ovarian hyperstimulation and intrauterine insemination as well as in vitro fertilization shown to be of benefit. Finally, the combination of in vitro fertilization and either medical or surgical therapy may be beneficial with advanced endometriosis, but further study is required.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Evidence-Based Medicine Combined Modality Therapy Danazol Danazol Endometriosis Endometriosis Endometriosis Endometriosis Female Humans Medroxyprogesterone Acetate Medroxyprogesterone Acetate Pain 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.

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Cited by (50)

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