Pharmacological treatment of endometriosis: review of current and new options for treatment

Maja Jakič, Andrej Vogler, Tea Lanišnik Rižner
In: Zdravniški Vestnik, Vol 85, Iss 7-8 (2016) · 2016 · W2531900065
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This review discusses current pharmacological treatments for endometriosis, including NSAIDs, oral contraceptives, and progestins, and explores emerging agents targeting inflammation, hormonal pathways, and other pathophysiological processes.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-06 ⓘ

This paper is a narrative review examining current and emerging pharmacological options for treating endometriosis, outlining diagnostic and treatment pathways at a high level. It reports that there is no established “optimal” treatment, but describes pharmacological therapy as indicated for empiric management of pelvic pain with normal exam findings and for recurrent disease after surgery, with common first-line agents including NSAIDs, oral contraceptives, and oral progestins. It states that GnRH agonists may be used as second-line therapy but their use is discouraged, and it categorizes newer investigational agents by mechanisms involving inflammation, hormonal disruption, immune dysfunction, apoptosis, angiogenesis, extracellular matrix degradation, oxidative stress, and epigenetic changes. The review’s major caveat is that most additional agents still require more convincing clinical studies before routine use can be supported. This paper is centrally about endometriosis — it reviews current and potential new pharmacological treatments for endometriosis and their proposed mechanisms and clinical status.

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Abstract

Endometriosis is a gynecological disease that is defined as the presence of endometrium-like tissue outside the uterine cavity, and it is one of the main causes of female infertility. Although there is unfortunately no known ‘optimal’ treatment for endometriosis, there are three treatment options: medication, surgical treatment, and a combination of both. The gold standard for diagnosis of endometriosis is a diagnostic laparoscopy, which is also therapeutic. Indications for pharmacological treatment of endometriosis include empirical treatment for patients with pelvic pain who are normal on gynecological examination, or who have recurrent disease after surgical treatment or in combination with surgical treatment. In everyday practice, non-steroid anti-inflammatory drugs, oral contraceptives, and progestins per os are used as first-line pharmacological treatments of endometriosis. Gonadoliberin agonists can be used as second-line treatment, although their use is discouraged. These medications can be used alone or in combination. Studies over the last 10 years have shown that many other agents have potential for treatment of endometriosis. These can be broadly classified into several groups: anti-inflammatory agents, and agents that interfere with the hormonal system, or with other pathophysiological processes, such as a disturbed immune system, reduced apoptosis, enhanced angiogenesis, degradation of the extracellular matrix, increased oxidative stress, and epigenetic changes. However, their introduction into routine use requires more convincing clinical studies to confirm their effectiveness.

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endometriosisinfertility

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