TY - CHAP M1 - Book, Section TI - Endometriosis 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 Y1 - 2020 N1 - T2 - Pharmacotherapy: A Pathophysiologic Approach, 11e 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. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1182462877 ER -