THE LATEST VIEWS ON THE TREATMENT OF ENDOMETRIOS

Halyna Semenyna, M.V. Doroshenko-Kravchyk, Тетяна Фартушок, Liliia Varvarych
In: Grail of Science · 2023 · pp. 402–407 · doi:10.36074/grail-of-science.10.11.2023.65 · W4389026458
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Endometriosis impacts multiple organs and its complex mechanisms hinder complete cure, though hormonal drugs have shown recent treatment success.

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This paper discusses the treatment landscape for endometriosis, focusing on how current therapies address implantation and growth of endometrioid lesions across different sites and severities. It highlights that systemic effects on distant organs (including liver, pancreas, thyroid, adrenal, cardiovascular, and nervous systems) occur and that the underlying mechanisms are complex and incompletely understood, limiting the likelihood of complete cure, although hormonal drugs have shown notable successes. A key caveat is that clinically inactive disease—especially peritoneal and ectocervical/extracervical localizations—requires careful differentiation because hormone therapy can sometimes activate disease processes. This paper is centrally about endometriosis — it provides an overview of current treatment approaches and the risks of hormonal therapy in clinically inactive forms.

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Abstract

Regardless of the localization and severity of clinical manifestations, E affects the functions of not only damaged and adjacent, but also distant organs: liver, pancreas and thyroid glands, adrenal glands, cardiovascular and nervous systems. The true mechanisms that regulate the processes of implantation and development of endometrioid heterotopias are complex and insufficiently studied, which does not allow us to assume the possibility of a complete cure, and in a number of patients, even achieving long-term remission or stopping the progression of the disease. Certain successes have been achieved in the treatment of E in recent years, especially in connection with the use of modern hormonal drugs. The treatment of clinically inactive E, which is more often observed in lesions of the peritoneum of the small pelvis, ectocervical and extracervical localizations, should be approached carefully and differentiated, since sometimes hormone therapy can contribute to the activation of the process.
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THE LATEST VIEWS ON THE TREATMENT OF ENDOMETRIOS DOI: https://doi.org/10.36074/grail-of-science.10.11.2023.65Keywords: endometriosis, hormonal drugs, nanoparticles, metformin, iron oxideSummary Regardless of the localization and severity of clinical manifestations, E affects the functions of not only damaged and adjacent, but also distant organs: liver, pancreas and thyroid glands, adrenal glands, cardiovascular and nervous systems. The true mechanisms that regulate the processes of implantation and development of endometrioid heterotopias are complex and insufficiently studied, which does not allow us to assume the possibility of a complete cure, and in a number of patients, even achieving long-term remission or stopping the progression of the disease. Certain successes have been achieved in the treatment of E in recent years, especially in connection with the use of modern hormonal drugs. The treatment of clinically inactive E, which is more often observed in lesions of the peritoneum of the small pelvis, ectocervical and extracervical localizations, should be approached carefully and differentiated, since sometimes hormone therapy can contribute to the activation of the process. Downloads Downloads License Copyright (c) 2023 Halyna Semenyna, Marta Doroshenko-Kravchyk, Tetiana Fartushok, Liliia Varvarych References Lagana A.S., Vitale S.G., Salmeri H. (2017) A Novel, Evidence-based, Unifying Theory for the Pathogenesis of Endometriosis. Med.Hypotheses, 103,10-20. Doi:10.1016/j/mehy.2017.03.032. DOI: https://doi.org/10.1016/j.mehy.2017.03.032 Lagana A.S., Vitale S.G., Gromese R., Palmara V. (2017) Clinical dynamics of Dienogest for the treatment of Endometriosis: From Bench to Bedside. Expert Opin. Drug Metab. Toxicol,13,595-596. DOI: https://doi.org/10.1080/17425255.2017.1297421 Patel B.G., Rudnicki M., Yu J., Shu Y., Taylor R.N. (2017) Progesterone resistance in endometriosis: Origins, consequences and interventions. Acta Obstet. Gynecol. Scand.,6,623-632. DOI: https://doi.org/10.1111/aogs.13156 Ayako Muraoka, Miho Suzuki, Tomonari Hamaguchi, Shinya Watanabe, Kenta Iijima, Yoshiteru Murofushi, Keiko Shinjo, Satoko Osuka, Yumi Hariyama, Mikako Ito, Kinji Ohno, Tohru Kiyono, Satoru Kyo, Akira Iwase, Fumitaka Kikkawa, Hiroaki Kajiyama, Yutaka Kondo. (2023) Fusobacterium infection facilitates the development of endometriosis through the phenotypic transition of endometrial fibroblasts. Science Translational Medicine, 15, 700. DOI:10.1126/scitranslmed.add1531 DOI: https://doi.org/10.1126/scitranslmed.add1531 Targeted Nanoparticles with High Heating Efficiency for the Treatment of Endometriosis with Systemically Delivered Magnetic Hyperthermia https://onlinelibrary.wiley.com/doi/epdf/10.1002/smll.202107808 Zaneta Kimber-Trojnar et al. (2022) Metformin as a potencial treatment option for Endometriosis. Cancers,14(3),577. Doi:103390/cancers14030577. DOI: https://doi.org/10.3390/cancers14030577 Jamali N., Zal F., Mostafavi-Pour Z., Samare-Najaf M. et al. (2021). Ameliorative effect of quercetin and metformin and their combination against experimental endometriosis in rats. Reprod. Sci,28,683-692. Doi:10.1007/s43.032-020-00377-2. DOI: https://doi.org/10.1007/s43032-020-00377-2 Soares S.R., Martinez-Varea A., Hidalgo-Mora J.J., Pellicer A. (2012) Pharmacologic therapies in endometriosis: A systematic review. Fertil.Steril, 98,529-555. Doi:10.1016/j.fertster.2012.07.11.20. DOI: https://doi.org/10.1016/j.fertnstert.2012.07.1120 Machado D.E., Saggioro E.M. et al. (2023) Clotrimazole is effective, safe and tolerable for the treatment of endometriosis and functions by downregulating inducible nitric oxide synthase and modulating oxidative stress biomarkers. Molecular and Cellular Endocrinolog, 564,111883. Doi:10.1016/j.mce.2023.111883. DOI: https://doi.org/10.1016/j.mce.2023.111883 Researchers optimistic about potential new treatment for endometriosis https://www.theguardian.com/profile/hannah-devlin Zhang H., Liu F., Huang Y., Liu W. (2023) The role of metformin in the management of endometriosis: A systematic review and meta-analysis. T.J.Pharm.Res, 22,5. Doi:10.4314/tjpr.v22i5.26. DOI: https://doi.org/10.4314/tjpr.v22i5.26 Bina F., Solcymani S., Tabarrai M., Abdollahi M., Rahinni R. (2019) Plant-derived medicines for treatment of endometriosis. Parmacol.Res, 139, 76-90. Doi:10.1016/j.phrs.2018.11.008. DOI: https://doi.org/10.1016/j.phrs.2018.11.008 Siedlak A., Kuc M., Cyboran K., Machaj D., Płaczek A. (2022) Complementary treatment of endometriosis: diet, physiotherapy and psychological treatment. Journal of Education, Health and Spor, 12(7),989-993. DOI: https://doi.org/10.12775/JEHS.2022.12.07.100 Markin L, Fartushok T, Mrochko Y, Pidhirnyj Y. (2022). MANAGEMENT OF PREGNANT WOMEN WITH COVID-19 − OWN EXPERIENCE. Georgian Medical News, 323,38-47. PMID: 35271469 Fartushok T.V., Semenyna H.B.,Starykovych A.V.(2021) Influence of leptin on the development and progression of obesity and concomitant diseases. MODERN ASPECTS OF MODERNIZATION OF SCIENCE IN UKRAINE: STATUS, PROBLEMS, DEVELOPMENT TRENDS. 102-105.

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