Medical Treatment of Endometriosis

Endometriosis is a common, benign and chronic gynecologicaldisorder. It is also an estrogen-dependent disorder thatcan result in substantial morbidity, including pelvic pain, progressivedysmenorrhea, dyspareunia, infertility and repeatsurgeries. Endometriosis is often treated surgically upon diagnosisbut with a higher rate of recurrence, suggesting that acombination of surgical and medical management might providebetter outcomes. The primary goal of medical treatmentfor endometriosis is to halt the growth and activity ofendometriosis lesions. The most widely utilized medical treatmentfor endometriosis involves use of gonadotropin-releasinghormone (GnRH) agonists and oral contraceptives.Conventional agents also include androgen derivates and progestins.Due to the chronic nature of this disease, long-term orrepeated courses of medication may be required to control itsrelated symptoms. Increasing knowledge about the pathogenesis of endometriosis at the cellularand molecular levels may give us the opportunity to use new, specific agents for treatment,including aromatase inhibitors, progesterone antagonists, selective progesteronereceptor modulators, GnRH antagonists, intrauterine releasing systems with progestin andnew pharmaceutical agents affecting inflammation, angiogenesis, and matrix metalloproteinaseactivity. Many of these promising new agents may prevent or inhibit the developmentof endometriosis. Further clinical trials may determine if these new therapies are superiorto current medical treatment strategies for endometriosis.