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

C.A. Coroleucă, D.Comandașu, C.B. Coroleucă, M. Mitran, E. Brătilă

Rezumat: 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.
Cuvinte cheie: endometriosis, management, recurrence, medical treatment, oral contraceptives, progestins, gonadotropin-releasing hormone, aromatase inhibitors.