Optimising Care For Endometriosis: New Therapeutic Options and Surgical Considerations — A Systematic Literature Review (SLR)

Parthasarathi Amirthalakshmi, Ghose Seetesh, Seetesh Ghose
In: Adolescência e Saúde · 2026 · pp. 1379–1390 · doi:10.67440/ahj.vi.2129 · W7213462973
Systematic review / meta-analysis OA: hybrid CC0
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This systematic review synthesizes recent evidence on endometriosis management, finding that newer oral GnRH antagonists consistently reduce pain and improve quality of life while surgical outcomes depend heavily on technique to preserve ovarian reserve.

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This systematic literature review evaluated recent advancements in therapeutic and surgical management for endometriosis, synthesizing data from fifteen clinical studies published between 2015 and 2025. The analysis found that newer oral gonadotropin-releasing hormone antagonists consistently reduced pelvic pain and improved quality of life, while surgical outcomes varied significantly based on the extent of the procedure and its impact on ovarian reserve. The authors emphasized that extensive surgical interventions are not always superior to less invasive techniques, highlighting the critical need for fertility-preserving approaches to protect reproductive potential. Ultimately, the paper argues for a patient-centered care model that integrates medical and surgical options to address symptom control, safety, and long-term well-being. This paper is centrally about endometriosis — specifically focusing on optimizing treatment strategies through a combination of new hormonal therapies and nuanced surgical considerations.

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Abstract

Endometriosis is a chronic gynaecological condition that is linked to pelvic pain, dysmenorrhea, infertility and poor quality of life (QoL) and now needs to be managed increasingly on an individual basis combining medical and surgical treatment. This systematic literature review assessed recent therapeutic and surgical considerations for the optimization of endometriosis treatment, focusing on pain control, QoL, fertility, ovarian reserve, recurrence, safety and postoperative outcomes. Original clinical studies published between 2015 to 2025 were identified through PubMed sand Google Scholar. Following duplications removal and eligibility screening, 15 studies were included and narratively synthesized based on therapeutic approaches, surgical management, reproductive outcomes, patient-reported outcomes and methodological quality. Newer oral gonadotropin-releasing hormone antagonists (elagolix, relugolix, and linzagolix) uniformly reduced dysmenorrhea and non-menstrual pelvic pain and improved functioning and QoL. Based on the surgical procedures, pain and QoL were also improved, but not in all cases the more extensive procedures were superior. It was demonstrated that the ovarian reserve was affected by surgical technique, underscoring the need for fertility preserving surgical techniques. Factors to consider for long-term results were recurrence, treatment safety, and repeat procedures. In summary, the ideal care of endometriosis must progress beyond the medical versus surgical dichotomy and exhibit a patient-centred approach that considers symptom management, safety, reproductive considerations and long-term QoL.
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Optimising Care For Endometriosis: New Therapeutic Options and Surgical Considerations — A Systematic Literature Review (SLR) DOI: https://doi.org/10.67440/ahj.vi.2129Keywords: Endometriosis; GnRH antagonists; Surgical management; Fertility preservation; Quality of life.Abstract Endometriosis is a chronic gynaecological condition that is linked to pelvic pain, dysmenorrhea, infertility and poor quality of life (QoL) and now needs to be managed increasingly on an individual basis combining medical and surgical treatment. This systematic literature review assessed recent therapeutic and surgical considerations for the optimization of endometriosis treatment, focusing on pain control, QoL, fertility, ovarian reserve, recurrence, safety and postoperative outcomes. Original clinical studies published between 2015 to 2025 were identified through PubMed sand Google Scholar. Following duplications removal and eligibility screening, 15 studies were included and narratively synthesized based on therapeutic approaches, surgical management, reproductive outcomes, patient-reported outcomes and methodological quality. Newer oral gonadotropin-releasing hormone antagonists (elagolix, relugolix, and linzagolix) uniformly reduced dysmenorrhea and non-menstrual pelvic pain and improved functioning and QoL. Based on the surgical procedures, pain and QoL were also improved, but not in all cases the more extensive procedures were superior. It was demonstrated that the ovarian reserve was affected by surgical technique, underscoring the need for fertility preserving surgical techniques. Factors to consider for long-term results were recurrence, treatment safety, and repeat procedures. In summary, the ideal care of endometriosis must progress beyond the medical versus surgical dichotomy and exhibit a patient-centred approach that considers symptom management, safety, reproductive considerations and long-term QoL.

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