title: Medical Management of Endometriosis in Patients with Chronic Pelvic Pain.
abstract: Endometriosis is a common cause of pelvic pain in women of reproductive age. Traditional medical therapies are hormonal in nature, including estrogen-progestin contraceptives, progestins, and gonadotropin-releasing hormone (GnRH) agonists. Other hormonal options are androgens and aromatase inhibitors, with research also suggesting a possible role for GnRH antagonists and selective progesterone receptor modulators. Other than nonsteroidal anti-inflammatories, further work is required for nonhormonal therapies such as antiangiogenic and immune-modulating drugs. Medical treatment of endometriosis can be complex, and requires consideration of side effects, the anatomic type of endometriosis, role of surgery, current infertility or future fertility desires, and other contributors to pain (e.g., central sensitization). These factors should be discussed for each patient, to ensure personalized treatment and optimal outcomes.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology, The University of British Columbia, Vancouver, Canada.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Bedaiwy
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology, The University of British Columbia, Vancouver, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Allaire
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology, The University of British Columbia, Vancouver, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Yong
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology, The University of British Columbia, Vancouver, Canada.
authors.forename: Sukinah
authors.initials: S
authors.lastname: Alfaraj
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy* / Q000209:etiology; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D017699:Pelvic Pain / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003278:Contraceptives, Oral, Hormonal; D007155:Immunologic Factors