Medical treatment of endometriosis: is it a choice of the physician?

Abstract

Introduction. Endometriosis is a chronic benign pathology and the long-term management plan should include me­di­cal treatment and surgical procedures. The current treat­ment of endometriosis is based on surgery and ova­rian suppressive agents. Materials and method. An ana­ly­sis of the articles published in the specialty li­te­ra­ture in order to evaluate the main pharmaceutical op­tions used in the treatment of endometriosis and the re­cur­rence rate of the disease. Results. Oral contraceptives, pro­ge­stins, gonadotropin-releasing hormone agonists and antagonists, and aromatase inhibitors are the most com­monly used agents in the treatment of endometriosis. Hor­mo­nal treat­ments are often associated with unwanted ef­fects, such as delayed conception and recurrence of the di­sease and symptoms when stopped. The recurrence rate of endometriosis after the surgical treatment is almost 50%. The use of oral contraceptives and progestins was de­mon­stra­ted to be effective in lowering the recurrence rate of en­do­me­trio­sis. Conclusions. Long-term medical therapy should be recommended for the treatment of endometriosis in or­der to control symptoms and to prevent recurrence after sur­gery. After first-line surgery, women should be informed of the high risk of endometriosis recurrence, and they should be invited to seek conception as soon as possible. An alternative is to inhibit ovulation until pregnancy is con­si­dered.