The Strategy of Pain Management in Women With Endometriosis

Background: patients with chronic pelvic pain associated with endometriosis, which is a puzzling and problematic gynecologic condition that has continued to plague women and baffle doctors and researchers worldwide. the present study aimed to examine the success strategy of pain management among women suffering from endometriosisMethods: Databases including Medline, EMBASE and Cochrane library were searched systematically to obtain English articles using relevant keywords. All study designs such as randomized clinical trials, cohort studies, casecontrol studies and case-studies focusing on medical treatment of endometriosis-related pain were included. Of 45 initially identified articles through electronic search, 38 relevant studies were selected of which, 22 were included in the final analysis. Results: Medications for endometriosis can becategorized into low-cost drugs including oral contraceptives (OCs) and most progestogens, and high-cost drugs including dienogest and GnRH agonists. As the individual response to different drugs is variable, a stepwise approach is Suggested, starting with OCs or low-cost progestogens, and stepping up to high-cost drugs only in case of inefficacy or intolerance. OCs may be used in women with dysmenorrhea as their main complaint, and when only superficial peritoneal implants or ovarian endometrioses.Conclusion: several drugs can be used with a similar magnitude of effect, in terms of pain relief, independently of the mechanism of action. Conversely, safety, tolerability, and cost differ. This has important practical implications, given that prolonged periods of treatment should be planned in symptomatic women not seeking pregnancy.

کلیدواژه ها:

Pain ، Management ، Endometriosis