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Today's treatments: medical, surgical and in partnership
1Department of Gynaecology, Catholic University of Louvain, Belgium.
Objective:
To provide an overview of the medical, surgical and combined therapy options for endometriosis.
Results:
Available medical options include danazol, progestogens, gestrinone, oral contraceptive agents, analgesics and gonadotropin-releasing hormone (GnRH) agonists. Used in the short-term, most of these agents relieve pain in a large proportion of patients and produce disease regression, however, they do not prevent recurrence, and are associated with side-effects. However, few data confirm any benefit of short-term medical therapy on fertility. One of the most promising medical approaches appears to be GnRH agonists with add-back hormone replacement therapy. Surgery may relieve pain, eradicate visible disease and improve fertility. A combined approach may facilitate surgery and relieve pain, although any fertility benefit is as yet unproven.
Conclusion:
Both short-term medical treatment and surgery relieve endometriosis-associated pain and decrease endometriotic implants. However, all approaches have side effects which must be balanced against the benefits when defining suitable treatment for a particular patient.