4.06 Pharmacology of Endometriosis

Abstract

Pharmacology of endometriosis is the science of drugs prescribed for endometriosis, and their effects on the disease and the patient. This is a clinician’s essay on the pharmacology of the disease. A brief mention of the pathogenesis of the disease is included. Available treatment options for endometriosis associated pain are included, and those for infertility associated to endometriosis briefly described. Mechanism of action of drugs, and description of hormonal receptors are discussed. Treatments are introduced beginning with progesterone and progestogens, followed by hormonal contraceptives, GnRH agonists, GnRH antagonists, a brief historical review of past treatments (including antiprogestogens and androgens), hormone releasing intrauterine devices and implants, estrogen antagonists and aromatase inhibitors. Formulas are shown for all compounds, and comments on efficacy and side effects are included. The purpose of this article is to describe current treatments and help the clinician to make decisions when confronted with a patient complaining of pain and low quality of life due to endometriosis.