Medical treatment of endometriosis: an update

Abstract

Endometriosis is defined as the presence of endometrial-like tissue (glands and stroma) outside the uterus, which induces a chronic inflammatory reaction, scar tissue, and adhesions that may distort a woman’s pelvic anatomy. Endometriosis is primarily found in young women, but its occurrence is not related to ethnic or social group distinctions. Patients with endometriosis mainly complain of pelvic pain, dysmenorrhea, and dyspareunia. Endometriosis is a very common debilitating disease that occurs in 6 to 10% of the general female population; in women with pain, infertility, or both, the frequency is 35-50%. This is an evidence based narrative review conducted by searching Medline up to (2017) and other online articles from Pubmed, Google scholar by using terms like Endometriosis, management, evidence based, updated treatment, pharmacoceutical hormon treatment and non-hormonal treatment. Articles were selected based on their currency and relevance to the discussion. Numerous cofactors can play a role in the progression and maintenance of endometriosis, which is thus a complex multifactorial disease. Hormonal therapy represents the treatment of choice in patients with endometriosis; with this in mind, we could consider CAM a supplementary option to be added to hormonal treatment, or as a valuable opportunity for those women in whom medical therapy is contraindicated.

Evaluation about Self-Care of the Patients with Endometriosis

“…Tuo tarpu akupunktūra ne tik sumažina skausmą, padidina skausmo slenkstį, suaktyvina skausmą malšinančius smegenų mechanizmus, bet ir padidina imuninės sistemos gebėjimą aktyviau pašalinti piktybines ląsteles, slopina endometriumo augimą [21]. Be to, akupunktūra padeda pagerinti endometrioze sergančių moterų gyvenimo kokybę ir socialinį gyvenimą [7].…”

Long-term treatment of endometriosis with dienogest: Real-world results from the VIPOS study

“…It is characterized by the presence of endometrial tissue outside the uterine cavity, which leads to inflammatory reactions and infiltration of anatomic structures. 1 The disease-associated symptoms such as pain, cramps and fatigue are debilitating and can profoundly affect women's quality of life in all aspects including sexual life, work life, and social relationships. [2][3][4][5] No permanent cure is available and the disease often recurs after discontinuation of medications or conservative therapies.…”

“…[2][3][4][5] No permanent cure is available and the disease often recurs after discontinuation of medications or conservative therapies. [6][7][8] The aim of endometriosis treatments is to alleviate disease-related symptoms and to improve the overall quality of life in affected individuals, 1,9,10 ideally by maximizing the use of medical treatment and avoiding repeated surgical procedures, especially in those women who wish to preserve fertility. 6,11 Adequate treatment often requires a dynamic multidisciplinary approach of surgical, hormonal and pain management strategies and may depend on the presented symptoms, endometriosis type and severity, as well as on the women's personal choice.…”

Patient-reported utilization patterns of endometriosis medications in Europe: Real-world results from the non-interventional VIPOS study

“…Endometriosis is a common gynecological disease characterized by the presence of endometrial-like tissue outside the uterine cavity. 1,2 The disease causes a chronic inflammatory reaction, scar tissue, and adhesions and is associated with a series of symptoms including chronic pelvic pain and infertility which can have a substantial burden on women's physical, mental, and social well-being. [2][3][4][5][6][7][8] Endometriosis affects around 10%-15% of all women of reproductive age, 40%-60% of women with dysmenorrhea and 20%-30% of women with decreased fertility; 9 however, the true prevalence and incidence are still not known.…”

“…1,2 The disease causes a chronic inflammatory reaction, scar tissue, and adhesions and is associated with a series of symptoms including chronic pelvic pain and infertility which can have a substantial burden on women's physical, mental, and social well-being. [2][3][4][5][6][7][8] Endometriosis affects around 10%-15% of all women of reproductive age, 40%-60% of women with dysmenorrhea and 20%-30% of women with decreased fertility; 9 however, the true prevalence and incidence are still not known. 10,11 Diagnostic measures for endometriosis currently range from non-invasive approaches based on clinical history, palpation, patient-reported symptoms, transvaginal, and transabdominal ultrasound and imaging procedures to laparoscopic inspection with subsequent histologic confirmation and often a combination of methods is applied.…”