Treatment of endometriosis-associated pain: An individualized approach

Objective: To conduct a systematic analysis of the data available in the modern literature on the efficacy, safety and pharmacodynamics of combined oral contraceptives (COCs), to evaluate the results of prospective clinical studies in the treatment of endometriosis-associated pain. Main points: Despite the fact that endometriosis continues to be one of the most common gynecological diseases, there are still considerable discussions in the scientific world regarding its diagnosis and treatment. Chronic pelvic pain, dysmenorrhea, dyspareunia, dyschezia and infertility are the key symptoms of the disease and seriously affect the quality of life. The combination of surgical and medical methods of treatment before and/or after surgery is one of the most common approaches to the management of endometriosis. Although COCs have been approved by a variety of clinical protocols and they are widely used to relieve pain in endometriosis, clinical studies confirming their effectiveness are few. Conclusion: According to the results of numerous studies, one of the most effective drugs for the treatment of endometriosis is a COC, Siluette. This oral contraceptive contains 30 mcg of ethinyl estradiol and 2 mg of dienogest and affects pathogenetic mechanisms of the disease. Due to dienogest, there is a high antiproliferative activity, activation of apoptosis, subsequent pseudodecidualization and suppression of neoangiogenesis which give the molecule non-contraceptive advantages. Therefore, the pain syndrome is significantly reduced, sexual function is restored and the quality of life is improved. © 2021, Bionika Media Ltd.. All rights reserved.