Abstract
To evaluate the effectiveness of a new class of medical drugs, namely oral gonadotropin-releasing hormone (GnRH) antagonists, in the management of premenopausal women with endometriosis-associated pelvic pain. We reviewed the most relevant papers (n = 27) on the efficacy of new medical alternatives (oral GnRH antagonists) as therapy for endometriosis. We first briefly summarized the concept of progesterone resistance and established that oral contraceptives and progestogens work well in two-thirds of women suffering from endometriosis. Since clinical evidence shows that estrogens play a critical role in the pathogenesis of the disease, lowering their levels with oral GnRH antagonists may well prove effective, especially in women who fail to respond to progestogens. There is a need for reliable long-term oral treatment capable of managing endometriosis symptoms, taking into consideration both the main symptoms and phenotype of the disease. Published studies reviewed and discussed here confirm the efficacy of GnRH antagonists. There is a place for GnRH antagonists in the management of symptomatic endometriosis. Novel algorithms that take into account the different phenotypes are proposed.
Highlights
The aim of this review is to present, based on recent literature, data on a new class of medical drugs, namely oral gonadotropin-releasing hormone (GnRH) antagonists, for the management of symptomatic endometriosis, a common chronic inflammatory disease causing pain and infertility [1,2,3] and affecting between 5% and 10% of women of reproductive age [1,3]
The goal of this review is to evaluate the place of several oral GnRH antagonists in the management of symptomatic endometriosis
Buggio et al [16] conducted an excellent review of available progestins used in the management of endometriosis, including norethisterone acetate (NETA), dienogest, desogestrel, cyproterone acetate, depot medroxyprogesterone acetate (DMPA), and the levonorgestrel-releasing intrauterine system (LNG-IUS)
Summary
The aim of this review is to present, based on recent literature, data on a new class of medical drugs, namely oral gonadotropin-releasing hormone (GnRH) antagonists, for the management of symptomatic endometriosis, a common chronic inflammatory disease causing pain and infertility [1,2,3] and affecting between 5% and 10% of women of reproductive age [1,3]. The goal of this review is to evaluate the place of several oral GnRH antagonists in the management of symptomatic endometriosis. The search was limited to peerreviewed full texts in English, reporting data on medical treatment by GnRH antagonist. GnRH antagonists in the management of endometriosis in symptomatic premenopausal women
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have