Hormonal therapy for endometriosis: from molecular research to bedside

Eur J Obstet Gynecol Reprod Biol. 2017 Feb:209:61-66. doi: 10.1016/j.ejogrb.2016.05.032. Epub 2016 May 27.

Abstract

Endometriotic lesions are associated with hormonal imbalance, including increased estrogen synthesis, metabolism and progesterone resistance. These hormonal changes cause increased proliferation, inflammation, pain and infertility. Hormonal imbalances are targets for treatment. Therapeutic strategies and innovations of hormonal drugs for endometriosis are increasing. Acting on estrogen receptors are hormonal drugs decreasing systemic and local estrogen synthesis (GnRH analogs, GnRH antagonists, Aromatase inhibitors) or estrogen activity (selective estrogen receptor modulators). The progesterone resistance is counteracted by progestins (Medroxyprogesterone acetate, Dienogest, Danazol, Levonorgestrel) or by Selective progesterone receptor modulators, a class of drugs under development. The future trend will be to define new drugs to use for prolonged period of time and with poor side effects considering endometriosis a chronic disease.

Keywords: Endometriosis; Estrogen secretion; Hormonal treatment; Pathogenesis; Progesterone receptor activity.

Publication types

  • Review

MeSH terms

  • Aromatase Inhibitors / therapeutic use*
  • Endometriosis / drug therapy*
  • Female
  • Hormone Antagonists / therapeutic use*
  • Humans
  • Levonorgestrel / therapeutic use*
  • Medroxyprogesterone Acetate / therapeutic use*
  • Selective Estrogen Receptor Modulators / therapeutic use*
  • Treatment Outcome

Substances

  • Aromatase Inhibitors
  • Hormone Antagonists
  • Selective Estrogen Receptor Modulators
  • Levonorgestrel
  • Medroxyprogesterone Acetate