Endometriosis in Italy: From cost estimates to new medical treatment

Abstract

Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induced a chronic inflammatory reaction. The data collected from Italy showed that around 3 million women are affected by endoemtriosis and the condition was predominantly found in women of reproductive age (50% of women were in the 29-39 age range), only 25% of women were asymptomatic. The associated symptoms can create an impact in general physical, mental, and social well-being. Endometriosis is associated with severe dysmenorrhea, deep dyspareunia, chronic pelvic pain, ovulation pain, cyclical, or perimenstrual symptoms, with or without abnormal bleeding, infertility, and chronic fatigue. The annual cost for hospital admission can be estimated to be in a total around 54 million euros. The average time for right diagnosis is around 9 years still today and it follows a long and expensive diagnostic search. Therapies can be useful to relieve and sometimes solve the symptoms, encourage fertility, eliminate endometrial lesions, and restore the anatomy of the pelvis. For medical therapy, several different preparations (oral contraceptives, progestogenics, gestrinone, danazol, and GnRHa) and new options (GnRH antagonists, aromatase inhibitors, estrogen receptor beta agoinist, progesterone receptor modulators, angiogenesis inhibitors, and COX-2 selective inhibitors) are available.

Proangiogenic Tie2+ Macrophages Infiltrate Human and Murine Endometriotic Lesions and Dictate Their Growth in a Mouse Model of the Disease

“…49 The identification of precise molecular targets is therefore a necessary step. Angiogenesis is a key event in the maintenance of endometrial lesions.…”

Case–control study to develop and validate a questionnaire for the secondary prevention of endometriosis

“…Recent studies revealed that the disease is present in around 1.5% of the general female population and 6-15% of hospitalized women [4]. The data provided by the Italian Agency for Medicinal Products report that in Italy the prevalence of endometriosis in asymptomatic women varies from 2% to 22%, depending on the diagnostic criteria used and the population studied: in women with severe dysmenorrhea and chronic pelvic pain the percentage ranges from 40 to 60% and in women with subfertility it sets around 20% and 30% [6].…”

Endometriosis, a disease of the macrophage

“…Endometriosis is a common condition, affecting a rather large fraction of menstruating women, characterized by the hormone-dependent persistence and growth of vascularized endometrial tissue at ectopic sites, typically the pelvis, with pain and reduced fertility (Lebovic et al, 2001; Giudice and Kao, 2004; Berkley et al, 2005; Bulun, 2009; Luisi et al, 2009; Giudice, 2010; Simoens et al, 2012). Lesions are thought to originate from endometrial fragments shed during menstruations, which reach via the Fallopian tubes the peritoneal cavity.…”