First-line hormone treatment for endometriosis
The review demonstrates that endometriosis is now considered as a chronic recurrent disease that requires early diagnosis and long-term, often combination treatment. It analyzes the efficacy of drugs used in the treatment of endometriosis and the mechanism of their action. First-line hormone therapy is recognized to be the use of currently available progestogens that can be successfully used in outpatient practice not only for relief of endometriosis-associated painful symptoms, but also for anti-relapse purposes after laparoscopic surgery. Dienogest is a thoroughly studied drug as this approach. The review considers the results of hormone treatment with a progestogen (a dienogest 2 mg tablet) that causes a decidual transformation, as well as anti-inflammatory and anti-angiogenic effects in the endometrioid explants, which can yield the favorable results of dienogest therapy in young patients with deep infiltrating endometriosis who have refused surgical treatment.Tikhomirov A.L.
Conclusion. It presents the importance of timely diagnosis of endometriosis and the feasibility of a combined approach to its treatment, including medical (nonsteroidal anti-inflammatory drugs, progestins, hormonal contraceptives, aromatase inhibitors, progesterone receptor modulators) and surgical methods.
Keywords
endometriosis
gestagens
dienogest
References
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Received 15.04.2021
Accepted 20.04.2021
About the Authors
Alexander L. Tikhomirov, MD, Professor of the Department of Obstetrics and Gynecology of the Medical Faculty, A.I. Evdokimov Moscow State Medical and Dental University, Ministry of Health of Russia; President of the Interregional Association of Doctors Engaged in the Study and Treatment of Uterine Fibroids.Tel.: +7(495)609-67-00. E-mail: pacificoff@mail.ru. 20/1, Delegatskaya str., Moscow, 127473, Russia.
For citation: Tikhomirov A.L. First-line hormone treatment for endometriosis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 5: 153-156 (in Russian)
https://dx.doi.org/10.18565/aig.2021.5.153-156
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