“These are experimental therapies,” Dr. Lamvu emphasized. “They may not work for some patients. Most of these therapies are recommended for only 3–6 months.”
Other future therapies include selective nonsteroidal aromatase inhibitors such as anastrozole and letrozole.
“The nice thing about these is that they're heavily studied in other disease processes such as cancer, so we have a lot more data as far as long-term side-effect profile and safety profile,” she said. “In pelvic pain these have only been studied for up to 6 months.”
Dr. Lamvu said she is most optimistic about the potential for new GnRH antagonists to make a significant improvement in chronic pelvic pain associated with endometriosis.
These agents “may work faster and have fewer side effects than the GnRH agonists that we now use,” she said.
Endometriosis seen laparoscopically needs to be histologically confirmed. ©Elsevier, Katz: Comprehensive Gynecology, 5th ed. Figure 8–9. 2007