Medical treatment of endometriosis-related pain

Paolo Vercellini, Laura Buggio, Buggio L, Frattaruolo MP, Maria Pina Frattaruolo, Alessandra Borghi, Borghi A, Dhouha Dridi, Edgardo Somigliana, Somigliana E
Best practice & research. Clinical obstetrics & gynaecology · 2018 · vol. 51 , pp. 68–91 · doi:10.1016/j.bpobgyn.2018.01.015 · PMID:29530425 · W2789651299
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This paper reviews medical treatments for pain associated with endometriosis, including hormonal therapies and pain relievers.

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Abstract

Available medical treatments for symptomatic endometriosis act by inhibiting ovulation, reducing serum oestradiol levels, and suppressing uterine blood flows. For this, several drugs can be used with a similar magnitude of effect, in terms of pain relief, independently of the mechanism of action. Conversely, safety, tolerability, and cost differ. Medications for endometriosis can be categorized into low-cost drugs including oral contraceptives (OCs) and most progestogens, and high-cost drugs including dienogest and GnRH agonists. As the individual response to different drugs is variable, a stepwise approach is suggested, starting with OCs or low-cost progestogens, and stepping up to high-cost drugs only in case of inefficacy or intolerance. OCs may be used in women with dysmenorrhea as their main complaint, and when only superficial peritoneal implants or ovarian endometriomas <5 cm are present, while progestogens should be preferred in women with severe deep dyspareunia and when infiltrating lesions are identified.

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Condition tags

dysmenorrheadyspareuniaendometriosis

MeSH descriptors

Chronic Pain Contraceptives, Oral Endometriosis Progestins Chronic Pain Chronic Pain Contraceptives, Oral Dysmenorrhea Dysmenorrhea Dyspareunia Dyspareunia Endometriosis Endometriosis Endometriosis Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Progestins Quality of Life

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 (100)

Cited by (50)

Source provenance

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License: CC0 · commercial use OK