Tohoku J. Exp. Med., 2006, 210(3)

Review

Management of the Pain Associated with Endometriosis: An Update of the Painful Problems

YUKA OZAWA, TAKASHI MURAKAMI, YUKIHIRO TERADA, NOBUO YAEGASHI, KUNIHIRO OKAMURA, SHINICHI KURIYAMA¹ and ICHIRO TSUJI¹

Department of Obstetrics and Gynecology, and ¹Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan

Endometriosis is a condition characterized by ectopic endometrial tissues located outside of the uterus, most commonly found on the pelvic peritoneum or ovary. Endometriosis, which occurs in 7-10% of women in the general population and 71-87% of women with chronic pelvic pain, is associated with dysmenorrhea, chronic pelvic pain, and infertility. There is considerable debate about the effectiveness of various interventions for endometriosis. This review discusses the benefits and drawbacks of pharmacologic and surgical treatments for the pain associated with endometriosis. Laparoscopic surgery has been demonstrated to relieve the pain associated with endometriosis. Hormonal therapies, such as gonadotropin-releasing hormone (GnRH) analogues or the weak androgen danazol, have also been effective at relieving the pain associated with endometriosis. Oral contraceptives appear to be as effective as GnRH analogues for pain relief. Although both surgical and pharmacologic treatments have been effective for relief of the pain associated with endometriosis, the recurrence rate remains significant. The management of pain associated with endometriosis has thus not been satisfied. Larger unified clinical trials are needed to evaluate the effectiveness of new treatments in managing the pain associated with endometriosis.

keywords —— endometriosis; pain management; meta-analysis

© 2006 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2006, 210, 175-188

Correspondence: Yuka Ozawa, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Japan.

e-mail: ozawa@mail.tains.tohoku.ac.jp