Modern ideas about the diagnosis and treatment of endometriosis

Over 100 years ago, endometriosis was described as endometrial-like tissue outside the uterus. There are many theories to explain endometriosis. Understanding the pathogenesis of any disease helps find the key to treatment. The evidence-based approach to endometriosis requires special consideration. Endometriosis is often ruled out because of the negative results of studies, including imaging, which results in a well-known diagnostic delay in the disease. Drug therapy is offered to relieve pain, to prevent new lesions or recurrences, and is prescribed as a self-treatment or as a second stage after surgery. In Russia, hormone therapy for endometriosis is used by only 24% of the women, for whom this is indicated. Informing women about their disease, the duration of treatment, possible side effects of hormone therapy, and ways to solve these problems will be able to reduce the risk of self-discontinuation of drugs and subsequent recurrences of endometriosis. Gestagen monotherapy to minimize the risk of progression of endometrioid lesions seems to be a more reasonable solution in the treatment of patients. The possible growth of lesions during therapy should be monitored and, if pain relief is inadequate, other options should be considered. Dydrogesterone is highly effective and safe in endometriosis; this allows you to take into account all the wishes of patients, which makes it possible to continue treatment for endometriosis for a long time before and after implementing reproductive plans, as well as before menopause.

Conclusion: Understanding the etiology and pathogenesis of endometriosis, timely diagnosis, and prescription of effective therapy with a high safety profile and with the ability to individually approach each patient will be able to alleviate symptoms, to improve quality of life, and to reduce the risk of recurrences in women suffering from this pathology.