THERAPEUTIC OPTIONS IN ENDOMETRIOSIS: A COMPARATIVE LITERATURE REVIEW OF INTRAUTERINE DEVICE THERAPY, SURGICAL TREATMENT, RELUGOLIX COMBINATION THERAPY, AND DIENOGEST

Katarzyna Ścibisz, Karolina Ollik, Kamil Harenza, Mateusz Taranowicz, Olga Kowalczyk, Dominika Zdobylak, Monika Kowalska, Anita Zieba, Michał Domin, Justyna Całka
In: International Journal of Innovative Technologies in Social Science · 2026 · vol. 2(1(49)) · doi:10.31435/ijitss.1(49).2026.4910 · W7139943975
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review compares the effectiveness and safety of levonorgestrel-releasing IUDs, relugolix therapy, surgery, and dienogest for endometriosis, finding that hormonal options offer the best long-term balance while surgery and relugolix are for specific cases.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This comparative literature review evaluated evidence from randomized controlled trials and meta-analyses on four treatment modalities for endometriosis-associated chronic pelvic pain: the levonorgestrel-releasing intrauterine system (LNG-IUS), oral relugolix combination therapy, surgical intervention (especially laparoscopic excision), and dienogest, focusing on pain reduction, safety, and long-term management considerations. Across the reviewed options, the paper reports meaningful pain relief, with surgery described as offering more rapid symptom improvement, particularly for deep infiltrating endometriosis, but also carrying invasiveness and recurrence risk. It characterizes LNG-IUS and dienogest as minimally invasive hormonal approaches with sustained analgesic efficacy and favorable safety profiles, while describing relugolix combination therapy as potent for severe symptoms with acceptable long-term safety when combined with add-back therapy, noting cost and monitoring requirements as potential limiting factors. This paper is centrally about endometriosis — it compares LNG-IUS, surgical treatment, relugolix combination therapy, and dienogest for symptom control and safety.

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Abstract

Endometriosis is a chronic, estrogen-dependent disease affecting women of reproductive age, associated with chronic pelvic pain, impaired fertility, and significant impairment of quality of life. The heterogeneous clinical presentation, variable disease severity, and high recurrence rates make therapeutic decision-making particularly challenging. This review summarizes and critically compares current evidence regarding four commonly used treatment modalities: the levonorgestrel-releasing intrauterine system (LNG-IUS), relugolix combination therapy, surgical intervention, and dienogest. The analysis focuses on their effectiveness in symptom reduction, safety profile, and suitability for long-term management. A review of randomized controlled trials and meta-analyses demonstrates that all reviewed modalities provide meaningful pain relief, though clinical applicability differs substantially. Surgical treatment, particularly laparoscopic excision, offers rapid symptom improvement, especially in deep infiltrating endometriosis, but is limited by invasiveness and recurrence risk. Dienogest and levonorgestrel-releasing intrauterine system represent minimally invasive hormonal options with sustained analgesic efficacy and favorable safety profiles, making them valuable for long-term disease control and postoperative maintenance. Relugolix combination therapy has emerged as a potent oral treatment for severe symptoms with acceptable long-term safety when combined with add-back therapy, although cost and monitoring requirements may limit its use. No single therapeutic approach can be universally recommended for all patients. Optimal management requires an individualized strategy that balances efficacy, safety, and long-term tolerability. Minimally invasive hormonal therapies offer the most favorable balance for long-term management, while surgery and relugolix therapy remain essential options for selected or refractory cases.

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Outcome instruments

EHP-30

Condition tags

endometriosisdie_deep_infiltratingchronic_pelvic_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.

References (33)

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last seen: 2026-06-10T17:14:06.276822+00:00
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