New insights on the pathogenesis of endometriosis and novel non-surgical therapies

Abstract

Endometriosis is a disease of theories, but none has succeeded to explain the whole picture. Most widely available drugs for endometriosis aimto relieve symptoms and improve fertility. Unfortunately, many short and long-term side-effects are associated with the treatments. To overcomethis problem, researchers have developed many novel therapeutic agents, including non-invasive technique. We aim to provide new insights onpathogenesis model and novel non-surgical treatments for endometriosis, including drugs already available in the market and also drugs whichare still under research. Seven novel treatment modalities are recognized, namely dienogest, aromatase inhibitor (AI), gonadotrophine-releasinghormone (GnRH) antagonist, anti tumor necrosing factor (TNF)-α, selective estrogen receptor modulator (SERM), selective progesteronereceptor modulator (SPRM), and high-intensity focused ultrasound (HIFU). Dienogest, AI, and GnRH antagonists are effective novel treatmentswith good tolerance and safety. SERM and SPRM show inconsistent results, while anti-TNF-α is still in the animal experimental stage. HIFU is apotential futuristic treatment. However, it is still a long way until this technology is truly applicable. (J Turk Ger Gynecol Assoc 2018; 19: 158-64)