[Medical treatment for the management of painful endometriosis without infertility: CNGOF-HAS Endometriosis Guidelines].

{"article_title":"[Medical treatment for the management of painful endometriosis without infertility: CNGOF-HAS Endometriosis Guidelines].","author":"Sauvan M, Chabbert-Buffet N, Canis M, Collinet P, Fritel X, Geoffron S, Legendre G, Wattier JM, Fernandez H","journal_title":"Gynecologie, obstetrique, fertilite & senologie","issn":"2468-7189","isbn":"","publication_date":"2018-03-01","volume":"46","issue":"3","first_page":"267","page_count":"","accession_number":"29510966","doi":"10.1016\/j.gofs.2018.02.028","publisher":"Elsevier Masson SAS","doctype":"Journal Article","subjects":"Endometriosis therapy; Analgesics therapeutic use; Complementary Therapies; Contraceptives, Oral; Dyspareunia etiology; Dyspareunia therapy; Endometriosis complications; Female; Humans; Intrauterine Devices, Medicated; Pelvic Pain etiology; Pelvic Pain therapy","interest_area":["Obstetrics & Gynecology"],"abstract":"Objective: To provide clinical practice guidelines for the management of painful endometriosis in women without infertility. Methods: Systematic review of the literature literature since 2006, level of evidence rating, external proofreading and grading of the recommendation grade by an expert group according to HAS methodology. Results: Combined hormonal contraceptives (COP) and the levonorgestrel-releasing intra-uterin system (LNG-IUS) are recommended as first-line hormonal therapies for the treatment of painful endometriosis (grade B). Second-line therapy relies on oral desogestrel microprogestative, etonogestrel-releasing implant, GnRH analogs (GnRHa) and dienogest (grade C). It is recommended to use add-back therapy containing estrogen in association with GnRHa (grade B). After endometriosis surgery, hormonal treatment relying on COP or LNG-IUS is recommended to prevent pain recurrence (grade B). COP is recommended to reduce the risk of endometrioma recurrence after surgery (grade B) but the prescription of GnRHa is not recommended (grade C). Continuous COP is recommended in case of dysmenorrhea (grade B). GnRHa is not recommended as first line endometriosis treatment for adolescent girl because of the risk of bone demineralization (grade B). The management of endometriosis-induced chronic pain requires an interdisciplinary evaluation. Physical therapies improving the quality of life such as yoga, relaxation or osteopathy can be proposed (expert agreement). Promising medical alternatives are currently under preclinical and clinical evaluation. Copyright \u00a9 2018 Elsevier Masson SAS. All rights reserved.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=29510966","isPdfLink":false,"isSAML":false,"an":"29510966","number_other":"","type_pub":"","issn_electronic":"2468-7189","languages":"French","language":"fre","date_entry":"Date Created: 20180308 Date Completed: 20181106 Latest Revision: 20181202","date_update":"20240104","titleSource":"Gynecologie, obstetrique, fertilite & senologie [Gynecol Obstet Fertil Senol] 2018 Mar; Vol. 46 (3), pp. 267-272. Date of Electronic Publication: 2018 Mar 03.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2018-03-01","description":"Objective: To provide clinical practice guidelines for the management of painful endometriosis in women without infertility.<br \/>Methods: Systematic review of the literature literature since 2006, level of evidence rating, external proofreading and grading of the recommendation grade by an expert group according to HAS methodology.<br \/>Results: Combined hormonal contraceptives (COP) and the levonorgestrel-releasing intra-uterin system (LNG-IUS) are recommended as first-line hormonal therapies for the treatment of painful endometriosis (grade B). Second-line therapy relies on oral desogestrel microprogestative, etonogestrel-releasing implant, GnRH analogs (GnRHa) and dienogest (grade C). It is recommended to use add-back therapy containing estrogen in association with GnRHa (grade B). After endometriosis surgery, hormonal treatment relying on COP or LNG-IUS is recommended to prevent pain recurrence (grade B). COP is recommended to reduce the risk of endometrioma recurrence after surgery (grade B) but the prescription of GnRHa is not recommended (grade C). Continuous COP is recommended in case of dysmenorrhea (grade B). GnRHa is not recommended as first line endometriosis treatment for adolescent girl because of the risk of bone demineralization (grade B). The management of endometriosis-induced chronic pain requires an interdisciplinary evaluation. Physical therapies improving the quality of life such as yoga, relaxation or osteopathy can be proposed (expert agreement). Promising medical alternatives are currently under preclinical and clinical evaluation.<br \/> (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&scope=site&db=mdl&AN=29510966&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Sauvan M, Chabbert-Buffet N, Canis M, Collinet P, Fritel X, Geoffron S, Legendre G, Wattier JM, Fernandez H"}