TY - CHAP M1 - Book, Section TI - Endometriosis A1 - Sturpe, Deborah A. A1 - Pincus, Kathleen J. A2 - DiPiro, Joseph T. A2 - Talbert, Robert L. A2 - Yee, Gary C. A2 - Matzke, Gary R. A2 - Wells, Barbara G. A2 - Posey, L. Michael Y1 - 2017 N1 - T2 - Pharmacotherapy: A Pathophysiologic Approach, 10e AB - KEY CONCEPTS Endometriosis should be suspected in any woman of reproductive age with recurring cyclic or acyclic pelvic pain and/or subfertility, especially if pain does not improve with nonsteroidal anti-inflammatory drugs and hormonal contraceptives. The etiology of endometriosis is likely multifactorial and requires a genetic or immunologic predisposition. Retrograde menstruation is the most widely accepted theory to account for displacement of endometrial tissue, although alternative theories have been proposed. Treatment goals include improvement of painful symptoms and maintenance or improvement of fertility. Therapy is considered successful based on resolution of symptoms or achievement of pregnancy. Both drug therapy and surgery may treat endometriosis-related pain, but infertility can be treated only with surgery or assisted reproductive techniques. No medical therapy has been proven to be more effective than another; thus, the choice among agents is determined primarily by side-effect profile, cost, and individual patient response. For endometriosis pain, surgical therapy is typically reserved for medical therapy failure. Diagnosis of endometriosis can be made only via surgical visualization of lesions, not by physical examination or laboratory testing. Empiric treatment without confirmation of diagnosis is acceptable in most cases. To help avoid loss of bone mineral density, add-back therapy should be used in any woman receiving a gonadotropin-releasing hormone agonist. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1145198856 ER -