Endometriosis. The case for early, aggressive treatment.
While the debate rages on regarding how metabolic and immunologic changes fit into the pathophysiology of endometriosis, the clinician must nonetheless make decisions regarding treatment. This article examines the relevant literature, with particular emphasis on immunologic aspects, nonclassic, early and deep disease as well as data on progression, recurrence and effects of treatment, to propose innovations in the management of early-stage disease. All symptomatic early-stage disease should be treated aggressively--even after conservative surgical resection of all apparent endometriosis, adjunct medical treatment in the form of a gonadotropin-releasing hormone agonist should be strongly considered.
Johnson
K M
KM
Overlake Reproductive Health, Bellevue, Washington 98004, USA.
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003276:Contraceptives, Oral / Q000627:therapeutic use; D018450:Disease Progression; D004412:Dysmenorrhea; D004414:Dyspareunia; D004715:Endometriosis / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007111:Immunity, Cellular; D007165:Immunosuppression Therapy; D017699:Pelvic Pain / Q000209:etiology / Q000628:therapy; D012008:Recurrence
D000894:Anti-Inflammatory Agents, Non-Steroidal; D003276:Contraceptives, Oral; D007987:Gonadotropin-Releasing Hormone