RT Book, Section
A1 Vest, Kathleen
A1 Lynch, Sarah E.
A2 DiPiro, Joseph T.
A2 Yee, Gary C.
A2 Posey, L. Michael
A2 Haines, Stuart T.
A2 Nolin, Thomas D.
A2 Ellingrod, Vicki
SR Print(0)
ID 1182462877
T1 Endometriosis
T2 Pharmacotherapy: A Pathophysiologic Approach, 11e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260116816
LK accesspharmacy.mhmedical.com/content.aspx?aid=1182462877
RD 2024/04/19
AB KEY  CONCEPTS  Endometriosis  is  a  chronic  condition  in  reproductive  age  women  that  can  cause  chronic  pelvic  pain  and  infertility.  Endometriosis  is  characterized  by  endometrial  tissue  outside  the  uterus,  but  the  exact  pathophysiology  and  biological  mechanisms  are  multifactorial  and  still  remain  unclear.  Endometriosis  should  be  suspected  in  any  woman  of  reproductive  age  presenting  with  recurring  pelvic  pain  or  otherwise  unexplained  infertility.  Failure  of  first-line  treatment  options  like  nonsteroidal  anti-inflammatory  drugs  (NSAIDs)  or  combined  hormonal  contraceptives  (CHCs)  to  relieve  dysmenorrhea  is  highly  suspect  of  endometriosis.  Definitive  diagnosis  of  endometriosis  requires  direct  surgical  visualization;  however,  it  is  acceptable  to  empirically  treat  these  symptoms  without  a  definitive  diagnosis.  Treatment  strategies  are  based  on  patient  symptoms  and  preferences  with  regards  to  desire  for  pregnancy.  Pharmacologic  and  surgical  options  are  indicated  to  treat  endometriosis-associated  pain.  Surgery/reproductive  technology  is  the  only  treatment  option  for  endometriosis-related  infertility.  Treatment  options  are  not  curative  of  endometriosis  and  only  provide  symptom  management.  First-line  pharmacologic  options  include  NSAIDs,  CHCs,  and  progestins.  Other  options  include  gonadotropin-releasing  hormone  (GnRH)  agonists,  GnRH  antagonists,  danazol,  and  aromatase  inhibitors.  Add-back  therapy  can  be  utilized  with  certain  agents  to  minimize  hypoestrogenic  adverse  events  such  as  bone  mineral  density  (BMD)  loss  and  vasomotor  symptoms.