Gestagens in pharmacotherapy for endometriosis: pathogenetic rationale, long-term clinical efficacy and safety

Endometriosis remains one of the most controversial diseases in modern gynecology. Many new discoveries regarding the pathogenesis of endometriosis raise even more questions in terms of therapeutic approaches to this nosology. According to international and federal guidelines, pharmacotherapy with gestagens is the preferred treatment for symptomatic endometriosis, but these protocols lack data on the specific advantages and disadvantages of such a broad pharmacological group. This review presents the most used gestagens in clinical practice not only from a pharmacological but also from a clinical-patho-genetic perspective to identify the most effective, safe, and prioritized progestin for the long-term treatment of endometriosis. © 2024, Dynasty Publishing House. All rights reserved.