Medikamentöse Therapie der Endometriose und Adenomyose

Background: The pharmacological therapy of endometriosis is a cornerstone in the therapy of endometriosis. Not only the right choice of the medication, but also the differentiation between the necessity of medical therapy or surgical intervention is a challenge in the therapy of endometriosis. Objective: The aim of this article is to demonstrate the different options for medical treatment, thus, providing support in the differentiation between the necessity of medical or surgical treatment. Material and methods: Various medical treatment options are presented and evaluated with regard to the current literature and guidelines. Results: Different treatment options are available like oral contraceptives, progestins, and gonadotropin-releasing hormone (GnRH) analogues. The off-label use of aromatase inhibitors is possible in some cases. New treatment options as selective progesterone receptor modulators (SPRM) and oral GnRH antagonists are expected in the future. Conclusion: There are numerous options for the treatment of endometriosis; however, most are used as off-label therapy. If medical treatment is not successful, surgery is an alternative. In view of the long latency between the first onset of symptoms and the diagnosis of endometriosis and due to the associated severe symptoms, surgery should not be delayed too long if medical treatment is not successful. A reliable diagnosis is only possible by laparoscopy and histological confirmation.