GnRH Antagonists with or without Add-Back Therapy: A New Alternative in the Management of Endometriosis?

To evaluate the effectiveness of a new class of medical drugs, namely oral gonadotropin-releasing hormone (GnRH) antagonists, in the management of premenopausal women with endometriosis-associated pelvic pain. We reviewed the most relevant papers (<i>n</i> = 27) on the efficacy of new me...

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Autores principales:	Jacques Donnez, Marie-Madeleine Dolmans
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	endometriosis pelvic pain dysmenorrhea progesterone resistance GnRH antagonist add-back therapy Biology (General) QH301-705.5 Chemistry QD1-999
Acceso en línea:	https://doaj.org/article/483696d0d6e14a3d866e8c287d5d1f24
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spelling	oai:doaj.org-article:483696d0d6e14a3d866e8c287d5d1f242021-11-11T16:49:14ZGnRH Antagonists with or without Add-Back Therapy: A New Alternative in the Management of Endometriosis?10.3390/ijms2221113421422-00671661-6596https://doaj.org/article/483696d0d6e14a3d866e8c287d5d1f242021-10-01T00:00:00Zhttps://www.mdpi.com/1422-0067/22/21/11342https://doaj.org/toc/1661-6596https://doaj.org/toc/1422-0067To evaluate the effectiveness of a new class of medical drugs, namely oral gonadotropin-releasing hormone (GnRH) antagonists, in the management of premenopausal women with endometriosis-associated pelvic pain. We reviewed the most relevant papers (<i>n</i> = 27) on the efficacy of new medical alternatives (oral GnRH antagonists) as therapy for endometriosis. We first briefly summarized the concept of progesterone resistance and established that oral contraceptives and progestogens work well in two-thirds of women suffering from endometriosis. Since clinical evidence shows that estrogens play a critical role in the pathogenesis of the disease, lowering their levels with oral GnRH antagonists may well prove effective, especially in women who fail to respond to progestogens. There is a need for reliable long-term oral treatment capable of managing endometriosis symptoms, taking into consideration both the main symptoms and phenotype of the disease. Published studies reviewed and discussed here confirm the efficacy of GnRH antagonists. There is a place for GnRH antagonists in the management of symptomatic endometriosis. Novel algorithms that take into account the different phenotypes are proposed.Jacques DonnezMarie-Madeleine DolmansMDPI AGarticleendometriosispelvic paindysmenorrheaprogesterone resistanceGnRH antagonistadd-back therapyBiology (General)QH301-705.5ChemistryQD1-999ENInternational Journal of Molecular Sciences, Vol 22, Iss 11342, p 11342 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	endometriosis pelvic pain dysmenorrhea progesterone resistance GnRH antagonist add-back therapy Biology (General) QH301-705.5 Chemistry QD1-999
spellingShingle	endometriosis pelvic pain dysmenorrhea progesterone resistance GnRH antagonist add-back therapy Biology (General) QH301-705.5 Chemistry QD1-999 Jacques Donnez Marie-Madeleine Dolmans GnRH Antagonists with or without Add-Back Therapy: A New Alternative in the Management of Endometriosis?
description	To evaluate the effectiveness of a new class of medical drugs, namely oral gonadotropin-releasing hormone (GnRH) antagonists, in the management of premenopausal women with endometriosis-associated pelvic pain. We reviewed the most relevant papers (<i>n</i> = 27) on the efficacy of new medical alternatives (oral GnRH antagonists) as therapy for endometriosis. We first briefly summarized the concept of progesterone resistance and established that oral contraceptives and progestogens work well in two-thirds of women suffering from endometriosis. Since clinical evidence shows that estrogens play a critical role in the pathogenesis of the disease, lowering their levels with oral GnRH antagonists may well prove effective, especially in women who fail to respond to progestogens. There is a need for reliable long-term oral treatment capable of managing endometriosis symptoms, taking into consideration both the main symptoms and phenotype of the disease. Published studies reviewed and discussed here confirm the efficacy of GnRH antagonists. There is a place for GnRH antagonists in the management of symptomatic endometriosis. Novel algorithms that take into account the different phenotypes are proposed.
format	article
author	Jacques Donnez Marie-Madeleine Dolmans
author_facet	Jacques Donnez Marie-Madeleine Dolmans
author_sort	Jacques Donnez
title	GnRH Antagonists with or without Add-Back Therapy: A New Alternative in the Management of Endometriosis?
title_short	GnRH Antagonists with or without Add-Back Therapy: A New Alternative in the Management of Endometriosis?
title_full	GnRH Antagonists with or without Add-Back Therapy: A New Alternative in the Management of Endometriosis?
title_fullStr	GnRH Antagonists with or without Add-Back Therapy: A New Alternative in the Management of Endometriosis?
title_full_unstemmed	GnRH Antagonists with or without Add-Back Therapy: A New Alternative in the Management of Endometriosis?
title_sort	gnrh antagonists with or without add-back therapy: a new alternative in the management of endometriosis?
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/483696d0d6e14a3d866e8c287d5d1f24
work_keys_str_mv	AT jacquesdonnez gnrhantagonistswithorwithoutaddbacktherapyanewalternativeinthemanagementofendometriosis AT mariemadeleinedolmans gnrhantagonistswithorwithoutaddbacktherapyanewalternativeinthemanagementofendometriosis
_version_	1718432236056870912

GnRH Antagonists with or without Add-Back Therapy: A New Alternative in the Management of Endometriosis?

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