THE MEDICAL TREATMENT OF MILD ENDOMETRIOSIS.

Area of Science:

• Gynecology
• Reproductive Medicine
• Pharmacology

Background:

• Mild endometriosis is frequently overlooked and left untreated.
• Natural history studies indicate a significant rate of disease progression in untreated patients.

Purpose of the Study:

• To evaluate the efficacy of gestrinone in treating mild endometriosis.
• To determine the natural progression of endometriosis and the impact of active treatment versus placebo.
• To assess the influence of treatment on subsequent fertility.

Main Methods:

• A double-blind, randomized controlled trial comparing gestrinone (2.5 mg twice weekly) with placebo.
• Laparoscopic assessment of endometriosis before and after treatment.
• 12-month follow-up to compare outcomes between treatment groups and disease states.

Main Results:

• 47% of patients receiving placebo showed disease progression.
• Gestrinone treatment resulted in significant disease improvement (p <0.004).
• No significant difference in outcomes was observed between active treatment and placebo groups during 12-month follow-up, nor between persistent and obliterated disease groups.

Conclusions:

• Active treatment for mild endometriosis is recommended to prevent disease progression.
• Expectant management is not advisable.
• Gestrinone demonstrates efficacy, and treatment does not appear to negatively impact subsequent fertility.
• Infertile patients with endometriosis may have underlying functional disorders that require active management to prevent further complications like adhesions.