Emerging mechanism-driven therapies for endometriosis: From GnRH antagonists to microbiome and device-based strategies (Review).
- 1Department of Medicine, Faculty of Medicine, Tbilisi State Medical University, Tbilisi 0177, Georgia.
- 2Department of Medicine, Faculty of Medicine, School of Health Sciences and Public Health, University of Georgia, Tbilisi 0177, Georgia.
Abstract
Millions of women of reproductive age suffer from endometriosis, a chronic, estrogen-driven condition that causes pelvic pain, dysmenorrhea and infertility. Conventional therapy focuses on symptom suppression with hormone medications or the surgical excision of lesions; however, it is not curative. Recent developments in the understanding of the pathophysiology of endometriosis have revealed novel immunological and molecular mechanisms that are being used in experimental therapies. The present review outlines developing techniques, including targeted endocrine modulators, epigenetic treatments, anti-inflammatory and immunomodulatory drugs, antioxidants, anti-angiogenic medicines, and microbiome-based therapy. Prominent examples are new oral gonadotropin-releasing hormone receptor antagonists, selective progesterone receptor modulators and aromatase inhibitors that aim to overcome progesterone resistance. Alternative methods, such nutraceuticals and biologic and small-molecule inhibitors (such as metabolic drugs and anti-cytokine therapies) are being explored. Novel supplemental options are provided by device-based neuromodulation and improved surgical techniques (such as advanced laparoscopy, robotic excision, image-guided surgery, nerve-sparing techniques and adhesion barriers). While many of these innovations are promising, current evidence is limited by small studies and disease heterogeneity. Future directions emphasize rigorous trials with standardized outcomes, including fertility measures and combinations of therapies to achieve personalized, long-term relief.
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BibTeX
@article{thomas2026emerging,
title = {{Emerging mechanism-driven therapies for endometriosis: From GnRH antagonists to microbiome and device-based strategies (Review).}},
author = {Krupa Sara Thomas and Subrahmaniyan Sujitha Lekshmi and Harshitha Gurrala and Mohamed Rayyan Ramzan and Ahmed Khalid Osman and Ziya Sherin},
journal = {Medicine international},
year = {2026},
month = sep,
doi = {10.3892/mi.2026.341},
url = {https://europepmc.org/article/MED/42923893},
note = {CC BY},
}
RIS
TY - JOUR
TI - Emerging mechanism-driven therapies for endometriosis: From GnRH antagonists to microbiome and device-based strategies (Review).
AU - Krupa Sara Thomas
AU - Subrahmaniyan Sujitha Lekshmi
AU - Harshitha Gurrala
AU - Mohamed Rayyan Ramzan
AU - Ahmed Khalid Osman
AU - Ziya Sherin
PY - 2026
DA - 2026/09/28
JO - Medicine international
DO - 10.3892/mi.2026.341
UR - https://europepmc.org/article/MED/42923893
AB - Millions of women of reproductive age suffer from endometriosis, a chronic, estrogen-driven condition that causes pelvic pain, dysmenorrhea and infertility. Conventional therapy focuses on symptom suppression with hormone medications or the surgical excision of lesions; however, it is not curative. Recent developments in the understanding of the pathophysiology of endometriosis have revealed novel immunological and molecular mechanisms that are being used in experimental therapies. The present review outlines developing techniques, including targeted endocrine modulators, epigenetic treatments, anti-inflammatory and immunomodulatory drugs, antioxidants, anti-angiogenic medicines, and microbiome-based therapy. Prominent examples are new oral gonadotropin-releasing hormone receptor antagonists, selective progesterone receptor modulators and aromatase inhibitors that aim to overcome progesterone resistance. Alternative methods, such nutraceuticals and biologic and small-molecule inhibitors (such as metabolic drugs and anti-cytokine therapies) are being explored. Novel supplemental options are provided by device-based neuromodulation and improved surgical techniques (such as advanced laparoscopy, robotic excision, image-guided surgery, nerve-sparing techniques and adhesion barriers). While many of these innovations are promising, current evidence is limited by small studies and disease heterogeneity. Future directions emphasize rigorous trials with standardized outcomes, including fertility measures and combinations of therapies to achieve personalized, long-term relief.
SN - 2754-3242
SN - 2754-1304
ER -