Today's treatments: how do you choose?

Barlow D, D Barlow
International Journal of Gynecology & Obstetrics · 1999 · vol. 64(S1) , pp. 15–21 · doi:10.1016/s0020-7292(98)00237-9 · PMID:10096460 · W2017955170
review OA: closed CC0 ⤵ 6 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-11 ⓘ

This review of randomized controlled trials and personal experience indicates that treatment choice for endometriosis is determined by clinician experience and patient acceptability, with several medical and surgical options demonstrating efficacy for pain and fertility.

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Abstract

OBJECTIVE: To provide a view on how the clinician can select appropriate treatment when managing individual patients with endometriosis. METHODS: Review of randomized controlled trials and personal experience. RESULTS: The main determinants of therapy choice are personal experience and patient acceptability. Placebo-controlled trial results support the use of naproxen, dydrogesterone, danazol and leuprolide for pain relief. Laser laparoscopy is more effective than expectant management for pain relief. In direct comparisons, oral contraceptives, Zoladex, danazol, gestrinone, nafarelin and leuprolide have similar efficacies in relieving pain, but have different side-effect profiles. In controlled trials, only laser laparoscopy was shown to improve fertility in minimal/mild disease. The physiological response of bone metabolism to GnRH agonist therapy should be seen in context and the place of add-back regimens understood. The general medical history of the patient must be considered when choosing therapy. CONCLUSIONS: The clinician must provide the patient with appropriate information on the treatment options to allow her to make an informed choice.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Female Humans Patient Satisfaction Randomized Controlled Trials as Topic

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 (19)

Cited by (6)

Source provenance

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License: CC0 · commercial use OK