Damewood M D
Women's Hospital Fertility Center, Johns Hopkins School of Medicine, Baltimore, MD.
J Fam Pract. 1993 Jul;37(1):68-75.
Endometriosis is a common disease that affects up to 5 million women in the United States. Specifically the prevalence of endometriosis is 1 in 15 (7%) women of reproductive age, and there is an associated incidence of infertility in as many as 30% to 40% of cases. The precise physiologic mechanism for the development of endometriosis lesions in the pelvis and abdominal cavity has not been elucidated. Substantial evidence exists, however, that endometriosis is dependent on estrogen for continued growth and proliferation. Therefore, suppression of the hypothalamic-pituitary-ovarian axis with analogues of a gonadotropin-releasing hormone is being increasingly undertaken. Since the most effective resolution of endometriosis occurs after oophorectomy or onset of menopause, the hypoestrogenic state induced by GnRH analogues is of major significance for patients with active disease. Medical therapy for endometriosis is often used as primary therapy for symptomatic disease or as an adjunct to surgical management of pelvic pain or infertility.
子宫内膜异位症是一种常见疾病，在美国影响着多达500万女性。具体而言，子宫内膜异位症在育龄女性中的患病率为十五分之一（7%），在多达30%至40%的病例中伴有不孕症。盆腔和腹腔内子宫内膜异位症病变发展的确切生理机制尚未阐明。然而，有大量证据表明，子宫内膜异位症的持续生长和增殖依赖于雌激素。因此，越来越多地采用促性腺激素释放激素类似物来抑制下丘脑-垂体-卵巢轴。由于子宫内膜异位症最有效的缓解发生在卵巢切除术后或绝经后，促性腺激素释放激素类似物诱导的低雌激素状态对患有活动性疾病的患者具有重要意义。子宫内膜异位症的药物治疗通常用作症状性疾病的主要治疗方法，或作为盆腔疼痛或不孕症手术治疗的辅助手段。
