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24.04.2023 | Gynäkologie

Medikamentöse Therapie der Endometriose – ein Update

verfasst von: Prof. Dr. med. Thomas Römer

Erschienen in: Wiener klinisches Magazin | Ausgabe 3/2023

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Zusammenfassung

Die Endometriose ist eine der häufigsten gynäkologischen Erkrankungen. In den meisten Fällen ist heute eine klinische Diagnostik möglich, sodass zunächst eine primäre medikamentöse Therapie erfolgen kann, wenn keine absoluten Operationsindikationen bestehen. Da es sich um eine chronische Erkrankung handelt, sind medikamentöse Langzeitbehandlungen sowohl in der primären Therapie als auch in der adjuvanten Therapie nach Operationen zu bevorzugen. Kombinierte orale Kontrazeptiva haben einen positiven Effekt auf die Dysmenorrhö, aber meist nicht auf die anderen Symptome. Des Weiteren sind hier entsprechende Kontraindikationen zu beachten und es ist mit einer potenziellen Progression der Erkrankung unter der Anwendung von kombinierten oralen Kontrazeptiva zu rechnen. Gestagene haben deshalb einen sehr hohen Stellenwert, da sie in der Langzeittherapie bei einem günstigen Nebenwirkungsprofil sehr effektiv sind. Dienogest hat hier gegenüber anderen Gestagenen klinisch relevante Vorteile. GnRH-Analoga und in Zukunft auch GnRH-Antagonisten stellen eine Second-line-Therapieoption dar. Für die Therapie der Adenomyosis ist die Anwendung eines Levonorgestrel-Intrauterinpessars mit 52 mg zu favorisieren. Der Stellenwert der medikamentösen Endometriosetherapie hat in den letzten Jahren deutlich zugenommen.
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Metadaten
Titel
Medikamentöse Therapie der Endometriose – ein Update
verfasst von
Prof. Dr. med. Thomas Römer
Publikationsdatum
24.04.2023
Verlag
Springer Vienna
Erschienen in
Wiener klinisches Magazin / Ausgabe 3/2023
Print ISSN: 1869-1757
Elektronische ISSN: 1613-7817
DOI
https://doi.org/10.1007/s00740-023-00494-z

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