MANAGEMENT OF ENDOMETRIOSIS: AN ENIGMATIC DISEASE

Endometriosis is an enigmatic disease that could start at birth which affects women of reproductive age. It is associated with hormonal imbalance, including increased estrogen synthesis, metabolism and progesterone resistance. These changes in hormones cause increased proliferation, inflammation, pain and infertility. The current treatments are surgical and hormonal but have limitations including risk of recurrence, side effects, contraceptive action for women who desire pregnancy and cost. New treatments include gonadotropin releasing hormone (GnRH) analogues, selective progesterone (or estrogen) receptor modulators, aromatase inhibitors, immunomodulators and antiangiogenic agents. More research is needed into central sensitization, local neurogenics and the genetics of endometriosis to identify additional treatment targets. Despite a range of symptoms, diagnosis of endometriosis is often delayed due to lack of non-invasive, definite and consistent biomarkers for diagnosis of endometriosis. The future trend will be to define new drugs to use for prolonged period of time and with poor side effects considering endometriosis a chronic disease. Aim of this review article is to understand and study the new molecules and conventional treatment that are effective for the management of endometriosis associated pain.