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Group A:
Drugs acting on H-P -G Axis (so multiple known / unknown systemic adverse
effects may ensue) e.g. OCP, and GnRHa. Both drugs are equally effective in
relieving pelvic pain but have different side effects and therefore vary in
terms of compliance. Of the two OC pill is less expensive than & GnRHa. The
problem is relapse is common immediately after stopping.
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Group B :- 1) NASIDs 2) SPRM( Mifepristone) , & Onapristone, 3)
Angiogenesis Inhibitors ( Inhibitors of VEGF and MNPs), 4) Progestogens ( Tab/Inj depot) have safest clinical
profile and most cost effective but not as effective as others Painful symptoms - efficacy is similar to
other drugs but the side effects are less and further reduced by the “add-back”
HRT 6) Dienogest
for 6 months,7) Aromatase Inhibitors 8) Danazol. 9)
Immunomodulatory drugs.10) selective
oestrogen receptor modulatory drugs.( loxoribine, TNF β & TNF-α inhibitors,
(Trade :-Name is Infliximab ) and
Pentoxyphylline. 8) Change of mode of drug delivery :-?? Local
Inj. of viscous progesterone at local sites by TVS right at the endometriotic
site .
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OC pill is
less expensive than Danazol & GnRHa but relapse is common immediately after
stopping
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GnRHa side
effects are less severe & manageable with therapy in contrast to those with
Danazol
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Progestogens
have safest clinical profile and most cost effective but not as effective as
others Painful symptoms - efficacy is
similar to other
drugs but the side effects are less and
further reduced by the “add-back” HRT
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Ovarian
endometrioma and rectovaginal endometriosis - drugs less effective
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Subfertility
- no role in stage I and II, but useful
before ART in stage III and IV.
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Painful
symptoms - efficacy is similar to other
drugs but the side effects are less and
further reduced by the “add-back” HRT
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Ovarian
endometrioma and rectovaginal endometriosis - drugs less effective
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Subfertility
- no role in stage I and II, but useful
before ART in stage III and IV
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