Endometriosis Research Advances
Endometriosis research is very active because endo is still a poorly understood condition. At G.O. Institute we are constantly looking for the latest research regarding endometriosis therapy. This is a very recent article which we hope will help you understand at least this part of endo treatment.
If this article seems to apply to your situation, please reach out to us and Dr. Steven Vasilev, our director. Since we are monitoring this research as it develops, we can use it to help you beat endometriosis and get your life back. Dr. Steven Vasilev is a renowned robotic endometriosis excision expert, focusing on recurrent and advanced endometriosis excision. Read it below and review the references, with links provided. This is an emerging and still controversial area of GnRH agonists vs antagonists but may offer relief for many women while minimizing the risks.
Although endometriosis is one of the most common gynecologic diseases, treatment options have long been limited. Commonly used medications include nonsteroidal anti-inflammatory drugs, progestins (including those in oral contraceptives), danazol, and GnRH agonists. Danazol and GnRH agonist use is associated with significant side-effects. Progestins use may also result in side-effects, including mood changes, breakthrough bleeding, breast tenderness, and bloating. Furthermore, progestins are not always effective; progestin resistance is common, occurring in 30%–50% of women using progestin-based therapies for endometriosis.Until recently, there has been little innovation in the treatment of this disease and there remained a pressing need for new therapies. Thankfully the introduction of GnRH antagonists has created a new option for women with endometriosis, especially those with progestin resistance or progestin-related side-effects. As opposed to GnRH agonists, which fully suppress the GnRH receptor and lower E2 levels to near zero, GnRH antagonists partially block the receptor in a dose-dependent fashion, allowing for a graded and titratable response. They are effective rapidly and without the initial stimulation of the GnRH receptor seen with GnRH agonists that leads to an E2 flare with symptom exacerbation. Furthermore, GnRH antagonists are administered orally and generally preferred by patients. Elagolix was the first GnRH antagonist to be available commercially for the treatment of endometriosis, and others are on the way in research.Linzagolix effectively alleviates endometriosis pain, either with or without estrogen add-back therapy. A paper published in Fertility and Sterility reports the first use of relugolix for this indication.
Flores V.A et al Progesterone receptor status predicts response to progestin therapy in endometriosis. Treatment of endometriosis-associated pain with elagolix, an oral GnRH antagonist. N Engl J Med. 2017; 377: 28-40
Donnez J. Treatment of endometriosis-associated pain with linzagolix, an oral gonadotropin-releasing hormone-antagonist: a randomized clinical trial. Fertil Steril. 2020; 114: 44-55
Osuga Y. et al Relugolix, an oral GnRH receptor antagonist, reduces endometriosis-associated pain in a dose-response manner: a randomized, double-blind, placebo-controlled study. Fertil Steril. 2021; 115
Agarwal S.K et al Clinical diagnosis of endometriosis: a call to action.
Am J Obstet Gynecol. 2019; 220: 354.e1-354.e12
Hugh S Taylor
This book by Dr. Steven Vasilev MD can help women with ovarian cysts, masses and tumors of all types, including endometriosis and endometriomas. He is a world-renowned expert on this topic.
To discover more about endometriosis and our unique treatment approach, please READ THIS