Innovations in the diagnosis and treatment of endometriosis: from the current advancements to a future outlook: A review

Mekan R. Orazov, Viktor E. Radzinsky, Evgeny D. Dolgov, Evgeny Dolgov
In: Gynecology · 2025 · vol. 27(4) , pp. 281–286 · doi:10.26442/20795696.2025.4.203490 · W7118014636
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review covers current evidence-based guidelines for endometriosis diagnosis and treatment, including dienogest therapy, and explores future prospects like anti-angiogenic drugs.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This review discusses innovations and future directions in diagnosing and managing endometriosis, summarizing evidence-based guideline approaches and emerging biomarker research. It highlights current diagnostic steps such as detailed history taking, physical examination, transvaginal or transabdominal/transrectal ultrasound (with reported diagnostic performance), selective use of MRI for suspected severe infiltrative disease, and diagnostic laparoscopy under specific conditions rather than as an automatic “gold standard.” For treatment, it emphasizes guideline-regulated management and notes dienogest (2 mg) as a progestogen “gold standard” pharmacotherapy shown to relieve symptoms and control progression and recurrence, while also considering future drug options including anti-angiogenic mechanisms. The paper explicitly notes limitations in the utility of laboratory testing and the heterogeneity of microRNA expression, which may restrict broad applicability despite promising developments such as saliva-based microRNA signatures and the Endotest pilot program. This paper is centrally about endometriosis — it reviews current diagnostic and therapeutic innovations, including dienogest and emerging microRNA-based testing approaches.

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Abstract

The search for approaches to diagnosing and treating endometriosis remains a priority in modern gynecology. The extremely high prevalence of this condition and its detrimental effect on somatic and reproductive health and the quality of life of patients determine the need for long-term therapy. The article describes evidence-based, modern guidelines-regulated approaches to the clinical management of patients with endometriosis. Currently, the arsenal of a modern clinician includes several technologies for effective clinical management of such patients (pain management, infertility treatment, monitoring the progression and recurrence of the disease, and quality of life). One such approach is the use of the “gold standard” pharmacotherapy for endometriosis with progestogens, namely dienogest 2 mg, which has been proven not only to relieve symptoms but also to effectively control endometriosis progression and recurrence. The immediate and long-term prospects for the diagnosis and treatment of endometriosis, in particular, drugs with an anti-angiogenic mechanism of action that can potentially change the prognosis of patients with this disease, are also considered.

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Condition tags

endometriosisinfertility

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 (26)

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