Novel pharmacological therapies for the treatment of endometriosis

Abstract

Introduction:Endometriosis is a chronic, estrogen-dependent, inflammatory disease associated with pelvic pain, infertility, impaired sexual function, and psychological suffering. Therefore, tailored patient management appears of primary importance to address specific issues and identify the appropriate treatment for each woman. Over the years, abundant research has been carried out with the objective to find new therapeutic approaches for this multifaceted disease.Areas covered: This narrative review aims to present the latest advances in the pharmacological management of endometriosis. In particular, the potential role of GnRH antagonists, selective progesterone receptor modulators (SPRMs), and selective estrogen receptors modulators (SERMs) will be discussed. We performed a literature search in PubMed and Embase, and selected the best quality evidence, giving preference to the most recent and definitive original articles and reviews.Expert opinion: Medical therapy represents the cornerstone of endometriosis management, although few advances have been made in the last decade. Most studies have focused on the evaluation of the efficacy and safety of GnRH antagonists (plus add-back therapy in cases of prolonged treatment), which should be used as second-line treatment options in selected cases (i.e. non-responders to first-line treatments). Further studies are needed to identify the ideal treatment for women with endometriosis.

Endometriosis and the Temporomandibular Joint—Preliminary Observations

“…However, the level of knowledge about endometriosis among women is insufficient, which may have an impact on the failure to see a specialist and thus delay the diagnosis of the disease and the initiation of treatment [44]. Although endometriosis may affect as many as 176 million women around the world, we still know little about the disease, and its causes are still being sought [45]. Most women with endometriosis report symptoms as early as puberty, and diagnosis is often delayed.…”

Endometriosis, the Silent Disease: Molecular Targets, Active Principles, and Drug Delivery Systems

“…[1] The aim of hormonal medication is to suppress estrogen enough to prevent endometriotic lesion growth and proliferation. [102] However, since low estrogen is associated with loss of bone mineral density, too much suppression of estrogen is undesirable. [102] The pituitary gland sits at the base of the brain and produces hormones such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH), known as gonadotropins.…”

“…[102] However, since low estrogen is associated with loss of bone mineral density, too much suppression of estrogen is undesirable. [102] The pituitary gland sits at the base of the brain and produces hormones such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH), known as gonadotropins. The hypothalamus releases gonadotropin-releasing hormone (GnRH), which stimulates the liberation of LH and FSH from the pituitary gland.…”

“…Hormonal medication is effective at suppressing the growth and proliferation of endometriosis lesions but can be considered only if the patient does not wish to conceive and experiences side effects to be acceptable [1] . The aim of hormonal medication is to suppress estrogen enough to prevent endometriotic lesion growth and proliferation [102] . However, since low estrogen is associated with loss of bone mineral density, too much suppression of estrogen is undesirable [102] …”

“…The aim of hormonal medication is to suppress estrogen enough to prevent endometriotic lesion growth and proliferation [102] . However, since low estrogen is associated with loss of bone mineral density, too much suppression of estrogen is undesirable [102] …”