Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (6): 46-50.doi: 10.6040/j.issn.1671-7554.0.2019.519

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Medical treatment of endometriosis: an update

PENG Chao, ZHOU Yingfang   

  1. Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
  • Published:2022-09-27

Abstract: Endometriosis(EMs)is a chronic and recurrent disease, and can hardly be cured by conservative surgery, so the medical treatment is very important. Many drugs have been developed for relieving pain symptoms associated with EMs, such as nonsteroids anti-inflammatory drugs(NSAIDs), conjugated oral contraceptives, progestins, gestrinone, 山 东 大 学 学 报 (医 学 版)57卷6期 -彭超,等.子宫内膜异位症的药物治疗 \=-gonadotropin-releasing hormone-agonists or GnRH-antagonists, and traditional Chinese medicine. Experts consensus has been achieved and published in 2018 in China on long-term maintenance therapy postoperatively to relieve pain and to prevent recurrence of EMs.

Key words: Endometriosis, Medical treatment, Maintenance therapy, Gonadotropin-releasing hormone-agonists, Gonadotropin-releasing hormone-antagonists, Progestins

CLC Number: 

  • R711.71
[1] 中华医学会妇产科学分会子宫内膜异位症协作组. 子宫内膜异位症的诊治指南[J]. 中华妇产科杂志, 2015, 50(3): 161-169.
[2] 周应芳. 子宫内膜异位症患者长期管理的必要性[J]. 中华妇产科杂志, 2017, 52(3): 145-146.
[3] 中华医师协会妇产科医师分会子宫内膜异位症专业委员会,中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症长期管理中国专家共识[J]. 中华妇产科杂志, 2018, 53(12): 836-841.
[4] Falcone T, Flyckt R. Clinical management of endometriosis[J]. Obstet Gynecol, 2018, 131(3): 557-571.
[5] Singh SS, Suen MW. Surgery for endometriosis: beyond medical therapies[J]. Fertil Steril, 2017, 107(3): 549-554.
[6] Chaichian S, Kabir A, Mehdizadehkashi A, et al. Comparing the efficacy of surgery and medical therapy for pain management in endometriosis: a systematic review and meta-analysis[J]. Pain Physician, 2017, 20(3): 185-195.
[7] Dunselman GA, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis[J]. Hum Reprod, 2014, 29(3): 400-412.
[8] Vercellini P, Buggio L, Somigliana E. Role of medical therapy in the management of deep rectovaginal endometriosis[J]. Fertil Steril, 2017, 108(6): 913-930.
[9] Mama ST. Advances in the management of endometriosis in the adolescent[J]. Curr Opin Obstet Gynecol, 2018, 30(5): 326-330.
[10] Kho RM, Andres MP, Borrelli GM, et al. Surgical treatment of different types of endometriosis: comparison of major society guidelines and preferred clinical algorithms[J]. Best Pract Res Clin Obstet Gynaecol, 2018, 51: 102-110. doi:10.1016/j.bpobgyn.2018.01.020.
[11] Vercellini P, Buggio L, Frattaruolo MP, et al. Medical treatment of endometriosis-related pain[J]. Best Pract Res Clin Obstet Gynaecol, 2018, 51: 68-91. doi:10.1016/j.bpobgyn.2018.01.015.
[12] ACOG Committee Opinion No. 760 summary: dysmenorrhea and endometriosis in the adolescent[J]. Obstet Gynecol, 2018, 132(6):1517-1518.
[13] Brown J, Crawford TJ, Allen C, et al. Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis[J]. Cochrane Database Syst Rev, 2017, 1: CD004753. doi:10.1002/14651858.CD004753.pub4.
[14] 程利南, 狄文, 丁岩, 等. 女性避孕方法临床应用的中国专家共识[J]. 中华妇产科杂志, 2018, 53(7): 433-447.
[15] 复方口服避孕药临床应用中国专家共识专家组. 复方口服避孕药临床应用中国专家共识[J]. 中华妇产科杂志, 2015, 50(2): 81-91.
[16] Caruso S, Iraci M, Cianci S, et al. Comparative, open-label prospective study on the quality of life and sexual function of women affected by endometriosis-associated pelvic pain on 2 mg dienogest/30 μg ethinyl estradiol continuous or 21/7 regimen oral contraceptive[J]. J Endocrinol Invest, 2016, 39(8): 923-931.
[17] Buggio L, Somigliana E, Barbara G, et al. Oral and depot progestin therapy for endometriosis: towards a personalized medicine[J]. Expert Opin Pharmacother, 2017, 18(15): 1569-1581.
[18] Bedaiwy MA, Allaire C, Alfaraj S. Long-term medical management of endometriosis with dienogest and with a gonadotropin-releasing hormone agonist and add-back hormone therapy[J]. Fertil Steril, 2017, 107(3): 537-548.
[19] Osuga Y, Fujimoto-Okabe H, Hagino A. Evaluation of the efficacy and safety of dienogest in the treatment of painful symptoms in patients with adenomyosis: a randomized, double-blind, multicenter, placebo-controlled study[J]. Fertil Steril, 2017, 108(4): 673-678.
[20] Andres Mde P, Lopes LA, Baracat EC, et al. Dienogest in the treatment of endometriosis: systematic review[J]. Arch Gynecol Obstet, 2015, 292(3): 523-529.
[21] Dragoman MV, Gaffield ME. The safety of subcutaneously administered depot medroxyprogesterone acetate(104 mg/0.65 mL): a systematic review[J]. Contraception, 2016, 94(3): 202-215.
[22] Carvalho N, Margatho D, Cursino K, et al. Control of endometriosis-associated pain with etonogestrel-releasing contraceptive implant and 52-mg levonorgestrel-releasing intrauterine system: randomized clinical trial[J]. Fertil Steril, 2018, 110(6): 1129-1136.
[23] Kim ML, Cho YJ, Kim MK, et al. The efficacy of long-term maintenance therapy with a levonorgestrel-releasing intrauterine system for prevention of ovarian endometrioma recurrence[J]. Int J Gynaecol Obstet, 2016, 134(3): 256-259.
[24] 郎景和, 冷金花, 王泽华, 等. 促性腺激素释放激素激动剂在子宫内膜异位症和子宫平滑肌瘤治疗中的应用专家意见[J]. 中华妇产科杂志, 2017, 52(2): 77-81.
[25] 郎景和,崔恒,戴毅,等. 2015年子宫内膜异位症的诊治指南专家解读[J]. 中华妇产科杂志, 2017, 52(12): 857-861.
[26] 贾双征, 冷金花, 孙蓬然, 等. 黑升麻提取物对子宫内膜异位症患者GnRH-a治疗期间低雌激素症状及生命质量的影响[J]. 中华妇产科杂志, 2015, 50(9): 692-693.
[27] Taylor HS, Giudice LC, Lessey BA, et al. Treatment of endometriosis-associated pain with elagolix, an oral GnRH antagonist[J]. N Engl J Med, 2017, 377(1): 28-40.
[28] Surrey E, Taylor HS, Giudice L, et al. Long-term outcomes of elagolix in women with endometriosis: results from two extension studies[J]. Obstet Gynecol, 2018, 132(1): 147-160.
[29] Barra F, Grandi G, Tantari M, et al. A comprehensive review of hormonal and biological therapies for endometriosis: latest developments[J]. Expert Opin Biol Ther, 2019, 19(4): 343-360.
[30] Perricos A, Wenzl R. Efficacy of elagolix in the treatment of endometriosis[J]. Expert Opin Pharmacother, 2017, 18(13): 1391-1397.
[31] Vercellini P, Viganò P, Barbara G, et al. Elagolix for endometriosis: all that glitters is not gold[J]. Hum Reprod, 2019, 34(2): 193-199.
[32] Markham A. Relugolix: first global approval[J]. Drugs, 2019, 79(6): 675-679.
[33] 段华, 汪沙, 郝敏, 等. 孕三烯酮使用中不规则子宫出血干预的多中心、随机、平行对照研究[J]. 中华妇产科杂志, 2016, 51(2): 98-102. DUAN Hua, WANG Sha, HAO Min, et al. Research of gestrinone-related abnormal uterine bleeding and the intervention in the treatment: a multi-center, randomized, controlled clinical trial[J]. Chinese Journal of Obstetrics and Gynecology, 2016, 51(2): 98-102.
[34] 周应芳. 子宫腺肌病药物治疗原则及注意事项[J]. 中国实用妇科与产科杂志, 2017, 33(2): 157-160. ZHOU Yingfang. Principles and precautions of medical treatment for adenomyosis of the uterus[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2017, 33(2): 157-160.
[35] Barra F, Scala C, Mais V, et al. Investigational drugs for the treatment of endometriosis, an update on recent developments[J]. Expert Opin Investig Drugs, 2018, 27(5): 445-458.
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