title: Long-term medical management of endometriosis with dienogest and with a gonadotropin-releasing hormone agonist and add-back hormone therapy.
abstract: Endometriosis can recur after either surgical or medical therapy. Long-term medical therapy is implemented to treat symptoms or prevent recurrence. Dienogest and gonadotropin-releasing hormone (GnRH) analogues with hormone add-back therapy seem to be equally effective for long-term treatment of pain symptoms associated with endometriosis. There is insufficient evidence to support the superiority of one therapy over the other. However, add-back hormone therapy (HT) is recommended for patients using GnRH agonists. The treatment selection depends on therapeutic effectiveness, tolerability, drug cost, the physician's experience, and expected patient compliance.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: mohamed.bedaiwy@cw.bc.ca.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Bedaiwy
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Allaire
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Sukinah
authors.initials: S
authors.lastname: Alfaraj
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004359:Drug Therapy, Combination; D004715:Endometriosis / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology; D004717:Endometrium / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D055118:Medication Adherence; D009277:Nandrolone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics; D017699:Pelvic Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology; D011372:Progestins / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined; D011372:Progestins; D007987:Gonadotropin-Releasing Hormone; C023635:dienogest; D009277:Nandrolone
keywords: Dienogest; GnRH-a; endometriosis; hormone add-back; long term