Weighing up GnRH agonist therapy for endometriosis: outcomes and the treatment paradigm
Expert Opinion on Pharmacotherapy,
Journal Year:
2025,
Volume and Issue:
unknown
Published: Jan. 25, 2025
Endometriosis
is
a
chronic
inflammatory
estrogen-dependent
disease
affecting
10%
of
women
worldwide
leading
to
pelvic
pain
and
infertility
which
may
be
treated
clinically
or
surgically.
Current
literaure
was
reviewed
using
the
keywords
'gonadotropin
releasing
hormone
agonists
(GnRHa),'
'endometriosis,'
'infertility'
'chronic
pain.'
Relevant
papers
prioritizing
randomized
controlled
clinical
trials
(RCT),
systematic
reviews,
meta-analyses,
as
well
international
guidelines
were
evaluated.
Available
options
for
relieving
endometriosis
associated
include
GnRHa,
progestagens
combined
oral
contraceptives
all
block
menstruation
control
symptoms
without
curing
disease.
GnRHa
administration
decreases
symptom
recurrency
after
surgical
treatment
but
side
effects
costs
limit
its
use.
Published
studies
test
effectiveness
in
easing
are
heterogeneous,
consider
different
outcomes
with
no
long
term
results.
Drug
choice
should
individualized
considering
side-effects
profile,
tolerability,
costs,
risks
benefits
one
size
does
not
fit
all.
As
we
wait
development
an
ideal
pharmacological
agente,
add-back
regimen
remain
second
line
option
alleviate
painful
endometriosis.
management
systemic
nature
complexity
involved
pathogenesis
symptoms.
Language: Английский
Adenomyosis: the missed disease
Reproductive BioMedicine Online,
Journal Year:
2025,
Volume and Issue:
50(4), P. 104837 - 104837
Published: April 1, 2025
Adenomyosis,
a
menstruation-related
uterine
disorder,
refers
to
the
presence
of
endometrial
stroma
and
glands
within
myometrium
is
typically
observed
in
reproductive-age
women.
The
pathogenesis
explaining
migration,
persistence,
proliferation
differentiation
ectopic
cells
includes
genetic
epigenetic
background,
an
oestrogen/progesterone
receptor
imbalance
inflammatory
reaction
driven
by
local
immune
dysfunction,
along
with
fibrosis
neuroangiogenesis
myometrium.
In
past,
it
was
thought
that
adenomyosis
almost
exclusively
affected
multiparous
women
after
40
years
age
diagnosis
generally
confirmed
upon
hysterectomy.
Nowadays,
using
imaging
techniques
such
as
transvaginal
ultrasonography
magnetic
resonance
imaging,
increasingly
identified
young
dysmenorrhoea,
dyspareunia,
abnormal
bleeding
heavy
menstrual
bleeding,
also
infertile
patients.
Furthermore,
often
coexists
other
gynaecological
conditions,
endometriosis
fibroids.
Despite
improvement
non-invasive
diagnostic
tools,
awareness
condition
still
poor
missed,
due
heterogeneity
clinical
presentation
criteria.
addition,
medical
surgical
management
do
not
follow
shared
recommendations,
even
though
requires
lifelong
plan,
including
pain
control,
fertility
preservation
pregnancy
complications.
Language: Английский