Medical management of endometriosis

Anais Alonso, Anaïs Alonso, Kate Gunther, Sarah Maheux-Lacroix, Sarah Maheux‐Lacroix, Jason Abbott
Current opinion in obstetrics & gynecology · 2024 · vol. 36(5) , pp. 353–361 · doi:10.1097/gco.0000000000000983 · PMID:39159261 · W4401688019
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review summarizes recent evidence on hormonal and nonhormonal medical management options for pelvic pain associated with endometriosis, highlighting first- and second-line treatments.

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Abstract

PURPOSE OF REVIEW: While laparoscopic surgery plays a key role in the management of endometriosis, symptoms commonly recur, and repeat surgery comes with increased risk. Medical management, including hormonal and nonhormonal treatment, is vital in managing painful symptoms. This review summarizes recent evidence regarding various medical management options available to treat pelvic pain associated with endometriosis. RECENT FINDINGS: Efficacy of dienogest vs. combined oral contraceptive on pain associated with endometriosis: randomized clinical trial.Once daily oral relugolix combination therapy vs. placebo in patients with endometriosis-associated pain: two replicate phase 3, randomised, double-blind, studies (SPIRIT 1 and 2).A randomized, double-blind, placebo-controlled pilot study of the comparative effects of dienogest and the combined oral contraceptive pill in women with endometriosis.Two-year efficacy and safety of relugolix combination therapy in women with endometriosis-associated pain: SPIRIT open-label extension study. SUMMARY: All symptomatic women with suspected endometriosis who are not desiring immediate fertility can be offered suppressive treatment to control symptoms and slow the progression of disease. First-line treatments include the combined oral contraceptive pill and progestogens. Second-line treatments include gonadotropin-releasing hormone agonists and antagonists but current guidelines recommend that these should be reserved for people whose symptoms fail to be controlled by first-line agents. The use of complementary and alternative medicines is also increasing in both volume and number of agents used.

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Outcome instruments

VAS-pain

Condition tags

mesh:D004715mesh:D017699endometriosis

MeSH descriptors

Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined 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 (54)

Cited by (19)

Source provenance

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