Prolonged hormonal therapy for endometriosis: how to make the right choice?

From the modern perspective, endometriosis is a chronic hormone-dependent disease tending to progress and recur, including after earlier surgical treatment. лечения. In view of this, a search for the optimal drug therapy that prevents relapses and that is effective and safe in its prolonged use is relevant. The paper reviews the Russian and foreign sources demonstrating the expendiency of using dienogest as a first-line therapy for endometriosis. One of the advantages of this progestagen is its pleiotropic mechanism of action, which directly or indirectly contributing to a decrease in the activity of endometrioid foci. Furthermore, the paper presents the data demonstrating the advantages of using dienogest both from the standpoint of prolonged therapy for different forms of endometriosis and in comparison with other drug treatments with gonadotropin-releasing hormone agonists, combined oral contraceptives, the levonorgestrel-containing intrauterine system, and other agents.

Conclusion: As of now, surgical and medical treatments for endometriosis are not contrasted, but complement each other. It is extremely important in the context of a decline in the rate of postoperative relapses, an improvement in life quality in the women, and a reduction in the risk of polycystic ovary syndrome. To date, dienogest is the drug of choice for good reason for prolonged therapy for endometriosis in view of not only the high activity of the drug against different forms of endometriosis, but also its safety during prolonged use.