Abstract

MEDICAL TREATMENT OF ENDOMETRIOSIS

Sanae Stimou*, Hafsa Taheri, Hanane Saadi and Ahmed Mimouni

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Abstract

Purpose: To review the literature on the medical treatment of endometriosis. Methods: Review of the literature between January 2006 and December 2022. The bibliographic search was performed on the Medline (Pubmed) and Cochrane databases. Meta-analyses, literature reviews, randomized controlled trials, cohort studies and retrospective studies were selected. Results: Hormonal treatment is the mainstay of medical treatment for endometriosis. Combined with specific pain treatment, it will provide significant relief and improve the quality of life of a number of women. Hormone therapy should make it possible to obtain amenorrhea, if possible, which seems to be more effective in terms of pain relief than cyclic treatment. The choice of hormonal treatment will be based on personal and family history and side effects. According to the recommendations for clinical practice (RPC) of the French National College of Gynecologists and Obstetricians (CNGOF), prescriptions will be- In 1st intention: Estrogen-progestin contraception, levonorgesterel 52 mg intrauterine system (LNG 52 mg IUD), dienogest. - 2nd line: Desogestrel contraception, etonogestrel implants, Gonadotropin Releasing Hormone (GnRH) agonists (with add-back therapy), The place of macroprogestins is not well defined. There is no established superiority of efficacy between cyclic or continuous COP, GnRH agonists, and continuous microprogestogen contraception for the management of painful non-operated endometriosis. Hormonal treatment makes it possible to reduce the volume of endometriomas and avoid ovarian surgery which is very harmful to the follicular capital. Prevention of recurrence is essential after surgery: this will require hormone therapy until the eventual desire for pregnancy.

Keywords: Endometriosis, Estrogen-progestin contraception, diénogest, hormonal traitement.