Medical treatment of endometriosis: an update

Endometriosis is defined as the presence of endometrial-like tissue (glands and stroma) outside the uterus, which induces a chronic inflammatory reaction, scar tissue, and adhesions that may distort a woman’s pelvic anatomy. Endometriosis is primarily found in young women, but its occurrence is not related to ethnic or social group distinctions. Patients with endometriosis mainly complain of pelvic pain, dysmenorrhea, and dyspareunia. Endometriosis is a very common debilitating disease that occurs in 6 to 10% of the general female population; in women with pain, infertility, or both, the frequency is 35-50%. This is an evidence based narrative review conducted by searching Medline up to (2017) and other online articles from Pubmed, Google scholar by using terms like Endometriosis, management, evidence based, updated treatment, pharmacoceutical hormon treatment and non-hormonal treatment. Articles were selected based on their currency and relevance to the discussion. Numerous cofactors can play a role in the progression and maintenance of endometriosis, which is thus a complex multifactorial disease. Hormonal therapy represents the treatment of choice in patients with endometriosis; with this in mind, we could consider CAM a supplementary option to be added to hormonal treatment, or as a valuable opportunity for those women in whom medical therapy is contraindicated.