Endometriosis: The Role of Pharmacotherapy

Objective: This review discusses the general principles on which classic and novel approaches in the pharmacotherapy of endometriosis are based and presents the types of drugs involved. Design: Review article. Data sources: Relevant studies were retrieved from Pubmed, Scopus and ISI -Web of knowledge databases. Eligibility criteria: All articles in English, French, German and Danish languages that contained the following keywords: endometriosis, pharmacotherapy, pain relief, chronic pelvic pain & infertility, were retrieved and read and all relevant data were included in this review. Results: Endometriosis is an estrogen-dependent, benign gynaecologic disorder, characterized by the presence of tissue morphologically and biologically similar to normal endometrium outside its normal location. The underlying aetiology and pathophysiology are poorly understood. Dyspareunia, dysmenorrhea, chronic pelvic pain and infertility are characteristic and debilitating manifestations of the disease. Several pharmacotherapeutic approaches are available. Currently available pharmacotherapies are not curative but symptomatic and aim either at decreasing ovarian estrogen production or at antagonizing estrogen action. Recurrence is the rule after cessation of treatment while pharmacotherapy is not suitable for women seeking conception. Conclusions: No curative pharmacotherapeutic options for treating endometriosis are currently available and most options complicate the course of treatment due to adverse events and short-term results. Novel approaches aim to take advantage of recent advances in endometriosis research but limited data are available regarding chronic use and long-term safety and efficacy. Keywords: Chronic pelvic pain, endometriosis, pain relief, pharmacotherapy