Audebert A
Rev Prat. 1999 Feb 1;49(3):269-75.
Medical treatment of endometriosis has been applied since 40 years. Its rational is based upon the hormone-dependency of the endometriotic lesions inducing a resting status. Adhesions, endometriomas or fibrous sequellae do not respond to medical treatment. Its use in case of associated infertility is very limited. Numerous agents are available for clinical use. Progestins are efficient on pelvic pain, contra-indications, clinical and metabolic tolerance are linked to the hormonal activity of the molecules. They have a low cost. Newer pills deserve to be evaluated. Danazol has now few indications in regards to its clinical and metabolic side-effects. Gn-RH analogs bear a potent efficacy and a very low intrinsic toxicity. They are preferentially used in severe cases, in association with surgery and before an IVF. Add back therapy improves the clinical tolerance and reduces bone mass loss. Many parameters should be taken into account when selecting a specific modality.
子宫内膜异位症的药物治疗已应用了40年。其原理基于子宫内膜异位病变的激素依赖性，从而诱导静止状态。粘连、子宫内膜瘤或纤维后遗症对药物治疗无反应。其在合并不孕症时的应用非常有限。有多种药物可供临床使用。孕激素对盆腔疼痛有效，其禁忌证、临床和代谢耐受性与分子的激素活性有关。它们成本低。新型药物值得评估。达那唑由于其临床和代谢副作用，目前适应证较少。促性腺激素释放激素（Gn-RH）类似物疗效显著且内在毒性极低。它们优先用于严重病例，与手术联合使用以及在体外受精（IVF）之前。反向添加疗法可提高临床耐受性并减少骨质流失。选择特定治疗方式时应考虑许多参数。
