Hormonal Treatment for Endometriosis, Adenomyosis, and Fibromatosis

In: Reproductive Medicine for Clinicians · 2026 · pp. 229–236 · doi:10.1007/978-3-032-07322-8_13 · W7127625766
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Hormonal treatments like progestins, oral contraceptives, and GnRH analogues manage endometriosis, adenomyosis, and fibromatosis symptoms by targeting sex steroid aberrations, impaired apoptosis, and inflammation.

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This chapter reviews medical/hormonal treatments for benign uterine conditions including endometriosis, adenomyosis, and fibromatosis, describing women at different ages and symptoms and focusing on off-label hormonal approaches used to control pain, abnormal uterine bleeding, and infertility. It summarizes a mechanistic rationale linking therapy to sex-steroid hormone aberrations, impaired apoptosis, and inflammation, and notes that progestins (e.g., dienogest, danazol, norethindrone acetate) are described as antiproliferative/anti-inflammatory for pain control, while a levonorgestrel-releasing intrauterine device is described as highly effective for abnormal uterine bleeding and reducing uterine volume long term. A key limitation explicitly stated is that the manuscript does not include primary research with human participants. This paper is centrally about endometriosis and adenomyosis — it provides a mechanistic and therapeutic overview of hormonal treatments used for their pain and bleeding manifestations.

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Abstract

Endometriosis, adenomyosis, and fibromatosis are benign uterine conditions affecting women at various ages with different symptoms. Medical treatment plays an important role in the management, especially in diffuse forms and in those women requiring preservation or restoration of fertility. Medical treatments are effective in improving symptoms: pain, abnormal uterine bleeding, and infertility, resulting very frequently in a more acceptable option than surgical treatment. The rationale for using medical treatment is based on the pathogenetic mechanisms of the diseases: sex steroid hormones aberrations, impaired apoptosis, and increased inflammation. Hormonal treatments (progestins, oral contraceptives, gonadotropin-releasing hormone analogues) are currently used off-label to control pain symptoms and abnormal uterine bleeding. An antiproliferative and anti-inflammatory effect of progestins, such as dienogest, danazol, and norethindrone acetate, suggests their use in medical management mainly to control pain symptoms. On the other hand, the intrauterine device releasing levonorgestrel resulted is extremely effective in resolving abnormal uterine bleeding and reducing uterine volume in a long-term management plan. In conclusion, based on new findings on pathogenetic mechanisms, new drugs are under development for the treatment of endometriosis, adenomyosis, and fibromatosis such as selective progesterone receptor modulators, aromatase inhibitors, valproic acid, and anti-platelets therapy. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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Rights and permissions Copyright information © 2026 The Author(s), under exclusive license to Springer Nature Switzerland AG About this chapter Cite this chapter Silvestri, C. et al. (2026). Hormonal Treatment for Endometriosis, Adenomyosis, and Fibromatosis. In: Genazzani, A.R., et al. Ethical, Efficacy and Safety Issues in Contraception. Reproductive Medicine for Clinicians, vol 4. Springer, Cham. https://doi.org/10.1007/978-3-032-07322-8_13 Download citation DOI: https://doi.org/10.1007/978-3-032-07322-8_13 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-032-07321-1 Online ISBN: 978-3-032-07322-8 eBook Packages: MedicineMedicine (R0)

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