Endometriosis-Induced Pain: The Treatment Strategy

Pain is one of the main symptoms in women with endometriosis. The mechanism of endometriosis-associated pain remains unclear but multiple factors, such as nociception, inflammation, alterations in the peripheral and central nervous systems, psychological aspects, and previous surgery, are involved. The management of women with endometriosis-associated pelvic pain is both medical and surgical. However, no treatment is curative since the disease is chronic, progressive, and tends to recur. Currently, the first-line drugs act by blocking the ovarian function, creating a hypoestrogenic environment. Progestins, Danazol, Gonadotropin-releasing hormone (GnRH) agonists, and GnRH antagonists are the most used hormonal treatments. Nonsteroidal anti-inflammatory (NSDAIs) drugs represent another medical option. Because of the complexity of the interventions, the average young age of patients, the possible desire for offspring, and the high rate of recurrence, surgery has limited indications and should be proposed as a second line after medical therapy. New future research about pathogenetic mechanisms of endometriosis could permit the development of ideal drugs that should relieve pain, induce regression of endometriotic lesions, and allow conception. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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