title: Endometriosis: current therapies and new pharmacological developments.
abstract: Endometriosis is a chronic inflammatory condition that is responsive to management with steroids. The establishment of a steady hormonal environment and inhibition of ovulation can temporarily suppress ectopic implants and reduce inflammation as well as associated pain symptoms. In terms of pharmacological management, the currently available agents are not curative, and treatment often needs to be continued for years or until pregnancy is desired. Similar efficacy has been observed from the various therapies that have been investigated for endometriosis. Accordingly, combined oral contraceptives and progestins, based on their favourable safety profile, tolerability and cost, should be considered as first-line options, as an alternative to surgery and for post-operative adjuvant use. In situations where progestins and oral contraceptives prove ineffective, are poorly tolerated or are contraindicated, gonadotrophin-releasing hormone analogues, danazol or gestrinone may be used. Future therapeutic options for managing endometriosis must compare favourably against existing agents before they can be considered for inclusion into current practice. Finally, as reproductive prognosis is not ameliorated by medical treatment, it is not indicated for women seeking conception.
authors.affiliation: Clinica Ostetrica e Ginecologica I, University of Milan, Milan, Italy. paolo.vercellini@unimi.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Vercellini
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
authors.forename: Paola
authors.initials: P
authors.lastname: Viganò
authors.forename: Annalisa
authors.initials: A
authors.lastname: Abbiati
authors.forename: Giussy
authors.initials: G
authors.lastname: Barbara
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Crosignani
mesh_terms: D002986:Clinical Trials as Topic; D003613:Danazol / Q000627:therapeutic use; D004358:Drug Therapy / Q000639:trends; D004715:Endometriosis / Q000188:drug therapy*; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D005867:Gestrinone / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000037:antagonists & inhibitors; D006801:Humans; D011372:Progestins / Q000627:therapeutic use
chemical_list: D004967:Estrogens; D011372:Progestins; D005867:Gestrinone; D007987:Gonadotropin-Releasing Hormone; D003613:Danazol