Pharmacological Treatment for Endometriosis-associated Pain

Endometriosis is recognized as a chronic, estrogen-dependent gynecological disorder, which is clinically defined by the presence and growth of endometrial-like tissue at anatomical sites outside the uterine cavity. The symptom is frequently linked to pelvic pain of prolonged duration, infertility, and ovarian endometriotic cysts. Current therapeutic strategies encompass both surgical intervention and a range of pharmacological approaches. This review focuses on pharmacological management of endometriosis-associated pain, covering established first-line therapies which are used most commonly, such as combined oral contraceptive pills and progestins, second-line options including nonsteroidal anti-inflammatory drugs and gonadotropin-releasing hormone (GnRH) agonists, as well as emerging treatments such as GnRH antagonists and aromatase inhibitors. The discussion begins with an overview of disease pathogenesis and the mechanisms underlying pain generation, followed by a detailed description of drug actions, evidence supporting their efficacy, potential adverse effects, and strategies to mitigate treatment-related complications. By summarizing the advantages and limitations of different pharmacotherapies, this review seeks to provide clinicians with a reference for individualized and safe treatment regimens, while also offering insights to the development of novel drugs and the optimization of therapeutic strategies in the future.