Analysis of pharmacological and surgical treatments for endometriosis
Koryagina O.S., Lebedeva D.I., Pavlova T.V., Konosevich D.O., Iotchenko M.Yu.
Endometriosis is a chronic condition characterized by severe pain, infertility, and reduced quality of life. This article presents the analysis of pharmacological and surgical treatments highlighted in systematic reviews and clinical studies. The efficacy of progestins, gonadotropin-releasing hormone (GnRH) agonists and antagonists, aromatase inhibitors, combined oral contraceptives, and other pharmacological agents is reviewed. The potential side effects, mechanisms of action of different drug groups and their effect on endometriotic lesions are discussed.
Particular attention is given to surgery including laparoscopic and laparotomic techniques and its impact on clinical and reproductive outcomes. The article presents the analysis of the advantages and limitations of surgical treatment including such parameters as remission duration and effects on ovarian reserve. The review provides the comparative analysis of treatment methods as well as the data on the recurrence rate, the need for adjuvant therapy and optimal management strategies for the patients with various types of the disease. The role of combination therapy that includes pharmacological treatment before and after surgery in reducing recurrence rate is considered. The article also examines the potential of emerging therapeutic strategies and highlights the need for further research to define optimal treatment regimens. The review demonstrated the importance of an individual approach and the integration of pharmacological and surgical methods for achieving the best therapeutic outcomes.
Conclusion: Pharmacological and surgical treatments for endometriosis have their benefits and limitations. Pharmacological treatment has been shown to be effective in relieving symptoms and reducing the risk of recurrence, but it comes with limitations in the duration of its use and side effects. Surgical treatment remains the standard for patients with advanced stages of the disease and infertility, since it provides significant improvements in reproductive and clinical outcomes. A combined approach, which includes pharmacological therapy before and after surgery, appears to be the most promising strategy.
Authors’ contributions: Koryagina O.S., Lebedeva D.I. – developing the concept and design of the study; Pavlova T.V., Konosevich D.O. – collecting and processing the material; Koryagina O.S., Pavlova T.V., Iotchenko M.Yu. – the analysis of the data; Iotchenko M.Yu., Lebedeva D.I. – writing the text; Koryagina O.S., Pavlova T.V. – editing the text. The authors contributed equally to writing the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
For citation: Koryagina O.S., Lebedeva D.I., Pavlova T.V., Konosevich D.O., Iotchenko M.Yu.
Analysis of pharmacological and surgical treatments for endometriosis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (7): 167-174 (in Russian)
https://dx.doi.org/10.18565/aig.2025.35
Keywords
endometriosis
pharmacological treatment
surgical treatment
progestins
GnRH agonists
aromatase inhibitors
laparoscopy
recurrences
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Received 17.02.2025
Accepted 04.06.2025
About the Authors
Olga S. Koryagina, 6th year medical student, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University),8-2 Trubetskaya str., Moscow, 119991, Russia, ol_koryagina@rambler.ru, https://orcid.org/0009-0006-2640-3651
Daria I. Lebedeva, 6th year medical student, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University),
8-2 Trubetskaya str., Moscow, 119991, Russia, ldasha2410@gmail.com, https://orcid.org/0009-0001-3228-8040
Tatyana V. Pavlova, 6th year medical student, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University),
8-2 Trubetskaya str., Moscow, 119991, Russia, Tatyana.Pavlova26@mail.ru, https://orcid.org/0009-0005-4110-2120
Daria O. Konosevich, 6th year medical student, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University),
8-2 Trubetskaya str., Moscow, 119991, Russia, Kono03.dar@yandex.ru, https://orcid.org/0009-0004-3964-6519
Mikhail Yu. Iotchenko, 6th year medical student, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University),
8-2 Trubetskaya str., Moscow, 119991, Russia, Iotchenkom@mail.ru, https://orcid.org/0009-0008-8517-6780
Corresponding author: Olga S. Koryagina, ol_koryagina@rambler.ru
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