Medikamentöse Therapie der Endometriose

Zusammenfassung Für die medikamentöse hormonelle Therapie der Endometriose sind in Deutschland das Gestagen Dienogest, die GnRH(„gonadotropin releasing hormone“)-Agonisten Leuprorelin, Goserelin und Nafarelin sowie, seit November 2023, der GnRH-Antagonist Relugolix-CT zugelassen. In der Erstlinientherapie bewährt haben sich bisher orale Gestagenpräparate, in der Zweitlinientherapie orale Östrogen-Gestagen-Kombinationspräparate, alternative Applikationsformen der Gestagene, wie zum Beispiel die Hormonspirale und die GnRH-Agonisten. GnRH-Agonisten haben aufgrund ihres Nebenwirkungsspektrums eine geringe Compliance und ihre Behandlung sollte durch eine Add-back-Therapie ergänzt werden. Eine weitere Möglichkeit ist nun die Therapie mit dem GnRH-Antagonisten Relugolix-CT nach vorangegangener medizinischer oder operativer Therapie. Die medikamentöse, nichthormonelle Therapie kann symptomatisch mit Analgetika, wie z. B. nichtsteroidalen Antirheumatika, erfolgen. Abstract In Germany, the progestin dienogest, the gonadotropin-releasing hormone (GnRH) agonists leuprorelin, goserelin, and nafarelin, and, since November 2023, the GnRH antagonist relugolix combination therapy (relugolix-CT) have been approved for hormonal drug therapy of endometriosis. In the first-line treatment of endometriosis, oral progestin preparations have proven effective. In second-line treatment, oral estrogen–progestin combination preparations, alternative forms of progestin administration such as the hormone coil, and GnRH agonists have proven effective. GnRH agonists have low compliance due to their range of side effects and their administration should be supplemented by add-back therapy. Another option is now treatment with the GnRH antagonist relugolix-CT following previous pharmaco- or surgical therapy. Non-hormonal drug therapy can be carried out symptomatically with analgesics such as nonsteroidal anti-inflammatory drugs. 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Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Additional information Redaktion Tanja Fehm, Düsseldorf Wolfgang Küpker, Baden-Baden Stefanie Burghaus, Erlangen Hinweis des Verlags Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral. QR-Code scannen & Beitrag online lesen Rights and permissions About this article Cite this article Burghaus, S., Beckmann, M.W. Medikamentöse Therapie der Endometriose. Gynäkologie 57, 146–153 (2024). https://doi.org/10.1007/s00129-024-05198-x Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00129-024-05198-x