New perspectives in the pharmacological approach to pain in women with endometriosis.

Abstract

Endometriosis is defined as the presence of stroma and endometrial glands outside the uterine cavity and is shown to be the main cause of pain in women. From the diagnosed cases, it is estimated that it affects around 10% of women in their reproductive age worldwide. Its etiology is varied and is associated with retrograde menstruation, metaplasia of mesothelial cells and endometrial tissue. It is frequently located in the uterus or in tissues attached to the uterus. Its management is empirical and focuses in symptomatic treatment of pain and surgical removal of ectopic tissue, in addition, hormonal suppression is necessary to avoid recurrences.

Objective: To carry out a review of the published literature on traditional and developing pharmacological medical treatments used for pain management in patients diagnosed with endometriosis in order to establish an adequate therapy based on current scientific evidence.

Methods: Bibliographic searches were carried out in virtual libraries such as PubMed Central, Cochrane Library, Cureus, New England Journal of Medicine. Review articles, randomized trials, and meta-analyses containing information on the studyn topic were collected and analysed by searching for keywords such as: “endometriosis + treatment”, “Hormonal treatments + endometriosis”, “NSAIDs + endometriosis” “pain management+ endometriosis” and “contraceptives + endometriosis”. The most recent studies from 2018 to the present date, in the languages of Spanish and English, were included.

Conclusions: Various therapeutic options are available for pain associated with endometriosis, which can be divided into non-hormonal and hormonal. NSAIDs are considered the treatment of choice due to their few side effects, their easy access and their wide availability. The choice of treatment depends on the patient, her needs and the factors that are analyzed by the doctor such as age, reproductive desire, severity of pain and adverse effects