Medical Treatments for Endometriosis-Associated Pelvic Pain

Gabriella Zito, Stefania Luppi, Elena Giolo, Monica Martinelli, Irene Venturin, Giovanni Di Lorenzo, Giuseppe Ricci
BioMed research international · 2014 · vol. 2014 , pp. 1–12 · doi:10.1155/2014/191967 · PMID:25165691 · PMC4140197 · W1976328610
review OA: gold CC0 ⤵ 76 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Continuous oral contraceptives and progestins are first-line treatments for endometriosis-associated pelvic pain, with GnRH analogues as a second-line option, while newer agents show promise but lack sufficient clinical evidence.

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Abstract

The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

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Condition tags

endometriosischronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Histone Deacetylase Inhibitors Pelvic Pain Progestins Endometriosis Endometriosis Endometriosis Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Histone Deacetylase Inhibitors Hormone Antagonists Hormone Antagonists Humans Pain Management Pelvic Pain Pelvic Pain Pelvic Pain Progestins

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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.

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Cited by (50)

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