Bedaiwy Mohamed A, Allaire Catherine, Yong Paul, Alfaraj Sukinah
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology, The University of British Columbia, Vancouver, Canada.
Semin Reprod Med. 2017 Jan;35(1):38-53. doi: 10.1055/s-0036-1597308. Epub 2016 Dec 21.
Endometriosis is a common cause of pelvic pain in women of reproductive age. Traditional medical therapies are hormonal in nature, including estrogen-progestin contraceptives, progestins, and gonadotropin-releasing hormone (GnRH) agonists. Other hormonal options are androgens and aromatase inhibitors, with research also suggesting a possible role for GnRH antagonists and selective progesterone receptor modulators. Other than nonsteroidal anti-inflammatories, further work is required for nonhormonal therapies such as antiangiogenic and immune-modulating drugs. Medical treatment of endometriosis can be complex, and requires consideration of side effects, the anatomic type of endometriosis, role of surgery, current infertility or future fertility desires, and other contributors to pain (e.g., central sensitization). These factors should be discussed for each patient, to ensure personalized treatment and optimal outcomes.
子宫内膜异位症是育龄女性盆腔疼痛的常见原因。传统医学疗法本质上是激素疗法，包括雌激素 - 孕激素避孕药、孕激素和促性腺激素释放激素（GnRH）激动剂。其他激素选择包括雄激素和芳香化酶抑制剂，研究还表明GnRH拮抗剂和选择性孕激素受体调节剂可能也起作用。除了非甾体抗炎药之外，抗血管生成和免疫调节药物等非激素疗法还需要进一步研究。子宫内膜异位症的医学治疗可能很复杂，需要考虑副作用、子宫内膜异位症的解剖类型、手术的作用、当前的不孕状况或未来的生育愿望以及其他疼痛因素（例如中枢敏化）。应该为每位患者讨论这些因素，以确保个性化治疗和最佳结果。
