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Today's treatments: medical, surgical and in partnership

1999; Elsevier BV; Volume: 64; Issue: S1 Linguagem: Inglês

10.1016/s0020-7292(98)00236-7

1879-3479

Jacques Donnez,

Gynecological conditions and treatments

Abstract 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.