New medical treatments in endometriosis

Pierre‐Emmanuel Bouet, Léa Delbos, Philippe Descamps, Guillaume Legendre
In: Médecine de la Reproduction · 2023 · vol. 25(2) , pp. 137–142 · doi:10.1684/mte.2023.0946 · W4385882681
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⚙ AI-generated summary by gemini-2.5-flash-lite+body, 2026-06-12 ⓘ

Dienogest is recommended as a second-line treatment for painful endometriosis, while relugolix combination therapy shows promise, and other medical alternatives are not yet viable.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

The paper reviews current and emerging medical treatments for painful endometriosis, focusing on medication-based management in patients without a desire for pregnancy. It describes how care has relied mainly on antigonadotropins and analgesics as a first step, with dienogest positioned as a more recent second-line option based on demonstrated efficacy. It also notes March 2023 French regulatory recommendations addressing the risk of meningioma associated with various progestins, including dienogest, and discusses relugolix combination therapy as a promising approach with reassuring early safety data after six months of use. It further states that antiaromatase therapies, selective estrogen receptor modulators, and selective inhibitors cannot yet be considered alternatives for the medical treatment of painful endometriosis. This paper is centrally about endometriosis — it summarizes evidence-based and newly emerging pharmacologic treatments for painful endometriosis, including dienogest and relugolix combination therapy, and addresses regulatory safety concerns.

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Médecine de la Reproduction MENULes nouveaux traitements médicaux de l’endométriose Volume 25, numéro 2, Avril-Mai-Juin 2023 - DOI : 10.1684/mte.2023.0946 - Page(s) : 137-42 - Année de parution : 2023 La prise en charge médicale de l’endométriose douloureuse est basée essentiellement sur des molécules antigonadotropes et des antalgiques en l’absence de désir de grossesse des patientes, et constitue la première étape thérapeutique. Le diénogest, traitement récent, a trouvé sa place dans l’algorithme de prise en charge de l’endométriose douloureuse au vu de son efficacité démontrée. Il est recommandé en deuxième intention. L’Agence nationale de sécurité du médicament vient très récemment (mars 2023) d’émettre des recommandations visant à encadrer le risque de survenue de méningiome pour différents progestatifs, dont le diénogest. La relugolix combination therapy, associant dans un même comprimé un antagoniste de la gonadolibérine et une addback therapy œstroprogestative, semble être un traitement prometteur dans l’endométriose douloureuse et les premières données sur la sécurité du traitement (après six mois de prise) sont rassurantes. Les antiaromatases, les modulateurs des récepteurs sélectifs de l’œstrogène ou les inhibiteurs sélectifs ne peuvent, pour le moment, être envisagés comme alternative thérapeutique dans le traitement médical d’une endométriose douloureuse.

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endometriosis

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