Current and emerging therapies for endometriosis-associated pain: a review

Ebunoluwa Oluwatimileyin Tijani, Lydia Oluwatoyin Ajayi, Oladimeji Samson Tijani, Oyedayo Phillips Akano, Ayodeji Folorunsho Ajayi
In: Middle East Fertility Society Journal · 2025 · vol. 30(1) · doi:10.1186/s43043-025-00221-0 · W4409441889
review OA: diamond CC0 ⤵ 7 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This review analyzes current pharmaceutical, surgical, and complementary pain management options for endometriosis, along with emerging therapies like SPRMs and stem cell treatments, highlighting the need for personalized approaches.

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

This narrative review assessed established and emerging therapies for endometriosis-associated pain, drawing on literature from sources including PubMed, Scopus, and Google Scholar and focusing primarily on studies published within the last decade. It summarizes that NSAIDs, hormone therapies (e.g., oral contraceptives, GnRH agonists/antagonists with possible add-back therapy, and progestins such as dienogest), and analgesics can alleviate symptoms but are often constrained by side effects and limited long-term effectiveness, while surgical approaches like laparoscopy and nerve ablation have recurrence rates that remain high. The review also covers complementary options such as acupuncture and physical therapy and describes emerging strategies including selective progesterone receptor modulators, aromatase inhibitors, gene-based therapies, advances in minimally invasive surgery, and regenerative medicine approaches like stem cell therapies, while noting the need for better evidence through long-term studies and real-world data. This paper is centrally about endometriosis — it reviews current and emerging treatments specifically targeting endometriosis-associated pain.

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Abstract

Abstract Background Endometriosis is a severe gynaecological disease marked by the formation of endometrial-like growth beyond the uterus, which causes severe pelvic pain, infertility, and a reduced standard of life. Despite the progress that has been made in understanding its aetiology, the treatment remains difficult due to the disease's complicated structure and diversity in different patient responses. Main body. This narrative review examines both present and emerging therapeutics for endometriosis-related pain, focusing on pharmaceutical, surgical, and complementary treatment options. Current pharmacological treatments, such as nonsteroidal anti-inflammatory medications (NSAIDs), hormone therapy, and analgesics, provide symptom alleviation but are frequently limited due to side effects and long-term effectiveness issues. Surgical procedures, such as laparoscopy and nerve ablation, provide alternatives, although recurrence rates remain high. Additionally, complementary therapies such as acupuncture and physical therapy are gaining recognition for their role in pain management. The review also explores emerging therapies, including novel pharmacological approaches like selective progesterone receptor modulators (SPRMs), aromatase inhibitors, and gene-based therapies. Advances in minimally invasive surgical techniques and regenerative medicine, such as stem cell therapies, are also discussed. Conclusion An essential comparison of these methods of therapy highlights the need for personalised approaches and further research to address variation of the disease. The review concludes with recommendations for subsequent studies, emphasising the need for long-term studies, real-world data, and innovations in pain management that integrate multifaceted therapies. This analysis aims to provide healthcare providers with a clearer understanding of the changing landscape of endometriosis treatment.

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Condition tags

endometriosisinfertility

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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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