The use of combined oral contraceptives in patients with endometriosis

Abstract

Endometriosis is a benign inflammatory hormone-dependent disease characterized by pain and infertility. It seriously affect women’s health., endometriosis is a chronic disease it requires long-term treatment. Currently, hormonal drugs are most widely used for the treatment of endometriosis, which is based on the endocrine mechanisms of its pathogenesis. Key points are estrogen dependence and progesterone resistance, which provide implantation of ectopic endometrial cells, reduce apoptosis and increase oxidative stress, inflammation and neuroangiogenesis. the pain and infertility is explained by hormonal and inflammatory changes, as well as the systemic diseases and psychiatric disorders often associated with endometriosis. Hormonal treatment of endometriosis is aimed at suppressing ovulation through inhibition of the hypothalamic-pituitary-ovarian axis, as well as directly on endometrioid implants. Gonadotropin-releasing hormone (GnRH) agonists and antagonists, progestins, combined oral contraceptives (COCs) are now offcially approved for use to relieve the symptoms of endometriosis. The review provides information on the current possibilities of hormonal therapy for endometriosis, based on an understanding of the pathogenesis of the disease.