Treatment strategies for endometriosis

Rodgers, Allison K.; Falcone, Tommaso

doi:10.1517/14656566.9.2.243

Cited by 67 publications

(41 citation statements)

References 81 publications

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“…Decreasing or eliminating the menstrual cycle (and tubaric reflux as a result) through the use of cyclic or continuous OCs may reduce the probability of cyst recurrence or peritoneal reimplantation [5]. The efficacy of postoperative OCs treatment is also supported by the theory that anovulation and moderately low oestrogen concentration may induce atrophy of the endometriotic implants [32], reduce disease-related pain [16], down-regulate cell proliferation and enhance programmed cell death (apoptosis) in the endometrium, which is abnormally low in women with endometriosis [33].…”

Section: Discussionmentioning

confidence: 99%

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Cucinella

Granese²,

Calagna

et al. 2013

Arch Gynecol Obstet

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Objective The primary aim of the study was to analyze the endometrioma recurrence rate in patients who underwent laparoscopic excision followed by postoperative longterm regimen of oral contraceptives (OCs). Materials and methods 168 patients who underwent a conservative laparoscopic surgery for endometrioma, during the period between September 2009 and August 2010 in three university hospitals were studied. A long-term OCs therapy was offered to all women following surgery. Patients were randomly divided into three groups according to different progestins used (desogestrel, gestodene, dienogest). Women who refused a postoperative hormonal therapy served as control. Follow-up visits and transvaginal scan were planned at 1, 3, 6, 12, and 24 months after surgery. All patients who showed an ultrasound persistence of the endometrioma at 1 month follow-up were excluded from clinical analysis.Results Of the 168 patients, 131 completed the 24 months follow-up. Endometrioma recurrence was found in 21 (12.5 %) of all patients, it was unilateral in 17 cases while bilateral in 4 cases. The rate of recurrent endometrioma was statistically significant in non-users compared to the long-term OCs treated patients. Conclusion The current data suggest the usefulness of long-term OCs regimen after conservative surgery for the prevention of ovarian endometrioma recurrence. As a statistical significant difference could not be observed between OCs groups, further study on the individual molecules is required in order to really understand the effect of each of them.

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Section: Discussionmentioning

confidence: 99%

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Cucinella

Granese²,

Calagna

et al. 2013

Arch Gynecol Obstet

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“…Progestagens, natural or synthetic steroid hormones that produce effects similar to progesterone (P4), are used in hormone therapy to counteract estrogen-induced proliferation of the endometrium (Rodgers and Falcone 2008). Aside from their local action, progestagens act at different body sites, including central nervous system (CNS) structures such as the prefrontal cortex, hippocampus, amygdala, and hypothalamus.…”

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confidence: 99%

Progesterone regulation of synaptic transmission and plasticity in rodent hippocampus

Foy¹,

Akopian²,

Thompson³

2008

Learn. Mem.

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Ovarian hormones influence memory formation by eliciting changes in neural activity. The effects of various concentrations of progesterone (P4) on synaptic transmission and plasticity associated with long-term potentiation (LTP) and long-term depression (LTD) were studied using in vitro hippocampal slices. Extracellular studies show that the highest concentration of P4 tested (10 −6 M) decreased the baseline synaptic transmission and magnitude of LTP, but did not affect LTD. Intracellular studies suggest the P4 effect to be mediated, at least in part, by GABA A activity. These results establish a general effect of P4 on synaptic transmission, multiple forms of synaptic plasticity, and a possible mechanism of P4 action in hippocampus.

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“…GnRHa and GnRH antagonists use results in a hypo estrogenic state with hot flushes and bone loss, which limits the treatment duration. Progestins, the other therapeutic option, can induce bloating, breakthrough bleeding, mood changes, acne, hirsutism that can alter therapeutic compliance [73].…”

Section: Treatment Of Endometriosismentioning

confidence: 99%

Gynaecological uses of a new class of steroids: the selective progesterone receptor modulators

Pintiaux

Chabbert-Buffet

Foidart

2009

Gynecological Endocrinology

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Treatment strategies for endometriosis

Cited by 67 publications

References 81 publications

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Oral contraceptives in the prevention of endometrioma recurrence: does the different progestins used make a difference?

Progesterone regulation of synaptic transmission and plasticity in rodent hippocampus

Gynaecological uses of a new class of steroids: the selective progesterone receptor modulators

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