Systemische Therapie der Endometriose: Alternativen zur Hormontherapie

Background Endometriosis is a one of the most common, benign but chronic diseases in women of reproductive age. The main symptoms are chronic and as a rule cycle-dependent pelvic pain and infertility. The etiology and pathogenesis of endometriosis are still unclear, a curative therapy is still lacking and the established options for therapy are mostly symptomatic. Other than surgical removal in this case laparoscopy is the gold standard, drug therapy plays an important role. In cases of infertility there is often an indication for assisted reproductive treatment.

The main aim of drug therapy is to achieve a hypoestrogenic state; therefore, oral contraceptives, gestagens and gonadotropin-releasing hormone (GnRH) analogues are used. Experimental options include aromatase inhibitors, GnRH antagonists, selective estrogen receptor modulators (SERM) and selective progesterone receptor modulators (SPRM). Furthermore, nonsteroidal anti-inflammatory drugs (NSAIRs), cyclooxygenase (COX)-2 inhibitors, angiogenesis inhibitors and immunomodulators can also be used.

Especially for women with severe pelvic pain syndrome a multimodal pain therapy should be offered, for example, acupuncture, physiotherapy or phytotherapy are complementary treatment options, although not being evidence based. This study gives an overview of current non-invasive non-hormonal treatment options. Similar content being viewed by others Literatur Allen C, Hopewell S, Prentice A, Gregory D (2009) Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis. Cochrane Database Syst Rev:CD004753 Becker CM, Sampson DA, Rupnick MA et al (2005) Endostatin inhibits the growth of endometriotic lesions but does not affect fertility. Fertil Steril 84(suppl 2):1144–1155 Bedaiwy M, Casper R (2006) Treatment with leuprolide acetate and hormonal add-back for up to 10 years in stage IV endometriosis patients with chronic pelvic pain. 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Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Braun, J., Schäfer, S. & Kiesel, L. Systemische Therapie der Endometriose: Alternativen zur Hormontherapie. Gynäkologe 48, 237–242 (2015). https://doi.org/10.1007/s00129-014-3421-1 Published: Issue date: DOI: https://doi.org/10.1007/s00129-014-3421-1