Endometriose, aktuelle medikamentöse Therapieempfehlungen mit Schwerpunkt auf der hormonellen Therapie mit Gestagenen

This paper reviews current medication recommendations for endometriosis, with a focus on hormonal therapy using progestins, describing high-level diagnostic elements and treatment goals across different clinical situations. It states that hormonal options include various contraceptives and progestins (e.g., dienogest 2 mg in Germany; others off-label), along with antiprogestins, GnRH agonists, and aromatase inhibitors, while analgesics are described as symptom-only; a key limitation acknowledged is that guideline recommendations are based on an older ESHRE guideline (2013, last updated several years earlier) and that diagnosis is often secured only via laparoscopy/biopsy even though empiric therapy may be possible in adequate symptom contexts. It highlights findings from studies such as an etonogestrel implant trial in 43 women with rectovaginal endometriosis (showing rapid pain reduction and decreased lesion volume with good tolerability, with further improvements mainly in those with high baseline pain scores) and a multicenter case-control study comparing dienogest 2 mg with a cyclic oral combined preparation containing dienogest plus ethinyl estradiol for endometrioma size reduction. This paper is centrally about endometriosis — it focuses on current medication recommendations, particularly progestin-based hormonal therapy.

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