virgola82
Forum Guru
Topics: 85
Posts: 348
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What is the first line treatment for endometriosis? In kaplan it says to start with leuprolide for few months to make the lesions shrink and then switch to oral contraceptives; on UW on the other hand it says that first line treatment is OCP and second line GnRH agonists.
What do you know about this?
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| usmlestud
Forum Junior
Topics: 6
Posts: 68
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depends on the severity of endometriosis and response to prior treatment.
the drugs include
NSAIDS
OCP
Progestins
Danazole
Aromatase inhibitors
GnRH analogues
The initial treatment is based on severity,symptoms .There is no standard first line drug
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| fudoc_20
Forum Newbie
Topics: 3
Posts: 46
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treatment of endometriosis depends on many things !first age of the pt and the severty of symptoms !,,and the extent of the lesion !!
so 1st minimal sympotms and minimal lesion the best thing is to make the pt get pregnant ! and treat pain by antiprostanglandins .as .state of pregnacy will induce decidual changes in the ectopic endometrium hoping it will regress after labour
2nd if sympotms is sever !,we .make her enter in something caled artificial menopause or pseudomenopause .during which she will have no pain no menses and no pregnancy !and we use for that hoping also that the ectopic endometrim under go regression
1 ocp 2.danazol .3.GNRH analouges .......
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| cirus
Forum Guru
Topics: 108
Posts: 740
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This part confuses me too..
so what ur saying is that:
1st line is OCPs ( I always choose it on UW, & always right)
2nd is Danazol
3rd is GnRH ( form what I know GnRH comes before Danazol dut to side effects of danaz-->Weight gain)
About preg, recent research proved that yes in preg Endomet will regress but after their is a very high chance of recurrence)
Surgery is used if pt is infertile & wants to get preg?? or we still try medical first??
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| dr_arc
Forum Senior
Topics: 5
Posts: 156
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1.pt with endometriosis + interested in starting family= advise pregnancy
2.young but not interested in pregnancy= pseudo pregnancy= OCP
or pseudomenopause = GnRH analogues i.e leuprolide
OCPS preffered cos leuprolide gives you pseudomenopause and all the morbidites that go with it i.e hot flashes etc.and cannot be given for a long time .also more expensive
danazol not used often , cos S/E unacceptable to most pts being antiandrogenic
3.endometriosis and infertile ..... hmm i remember reading somewhere that it was short course of Gnrh foll by clomiphene. (will have to confirm this one though).
pharmacotherapy fails = surgery.
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| rockingdoctor
Forum Elite
Topics: 23
Posts: 291
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dr_arc is right
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Impossible is nothing !
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