Endometrioizis ve Cinsel Disfonksiyon
Synopsis
Cinsel işlev bozuklukları, özellikle cinsel ağrı, her yaştan yetişkin kadında yaygındır. Endometriozis, kadınların cinsel yaşamı üzerinde olumsuz bir etkiye sahiptir. Üreme çağındaki kadınları etkileyen kronik bir jinekolojik ağrı durumu olan endometriozisli hastalarda cinsel ağrı en sık görülen üçüncü semptomdur. Endometriozis ile ilişkili cinsel ağrıda doku hasarı, inflamasyon, hormonal değişiklikler, periferik ve merkezi sinir sistemindeki değişiklikler ve pelvik taban kas fonksiyon bozuklukları gibi birçok biyolojik faktör rol oynar. Tedavide sentetik steroid ilaçlar, hormonlu rahim içi araç, implantlar ve NSAİD kullanılabilmektedir.
Sexual dysfunctions, especially sexual pain, are common in adult women of all ages. Endometriosis has a negative impact on the sex life of women. Sexual pain is the third most common symptom in patients with endometriosis, a chronic gynecological pain condition that affects women of reproductive age. Many biological factors play a role in sexual pain associated with endometriosis, including tissue damage, inflammation, hormonal changes, changes in the peripheral and central nervous system, and pelvic floor muscle dysfunctions. Synthetic steroid drugs, hormonal intrauterine device, implants and NSAIDs can be used in the treatment.
References
Laganà, A. S., La Rosa, V. L., Rapisarda, A. M. C., Valenti, G., Sapia, F., Chiofalo, B., Rossetti, D., Ban Frangež H. B., Vrtačnik Bokal, E., Vitale, S. G., “Anxiety and depression in patients with endometriosis: impact and management challenges”, Int. J. Womens Health.,323-330, 2017. 9.
Marinho, M. C. P., Magalhaes, T. F., Fernandes, L. F. C., Augusto, K. L, Brilhante, A. V. M., Bezerra, L. R. P. S., “Quality of life in women with endometriosis: An integrative review”, Int. J. Womens Health (Larchmt)., 27 (3), 399-408, 2018. 48
Chaman-Ara, K., Bahrami, M. A, Bahrami, E., “Endometriosis psychological aspects: A literature review”, J. Endometr. Pelvic Pain Disord.,, 9 (2), 105-111, 2017.
Hickey, M., Ballard, K., Farquhar, C. “Endometriosis”, BMJ, 348: g1752, 2014.
Mehedintu, C., Plotogea M. N., Lonescu, S., Antonovici, M., “Endometriosis still a challenge”, J. Med. Life., 7 (3), 349-357, 2014.
Berker, B., Seval, M., “Problems with the diagnosis of endometriosis”, Womens Health (Lond)., 11 (5), 597-601, 2015.
Aşçı, Ö., Kocaöz, S., “Üreme organları tümörleri”, Hemşirelik ve Ebelik için Kadın Sağlığı ve Hastalıkları, Editör, Arslan Özkan, H., Akademisyen Kitapevi, Ankara, 673-720, 2019.
Ballard K. D., Seaman, H. E., de Vries, C. S., Wright, J. T., “Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control studyPart 1”, BJOG, 115 (11), 1382–1391, 2008
İnternet: World Health Organization “Endometriosis” https://www.who.int/newsroom/fact-sheets/detail/endometriosis
Vitale, S. G., La Rosa, V. L., Rapisarda, A. M. C., Laganà, A. S., “Impact of endometriosis on quality of life and psychological well-being”, J. Psychosom. Obstet. Gynaecol., 38 (4), 317-319, 2017.
Giudice LC (2010) Clinical practice. Endometri N Engl J Med 362(25):2389–2398.
Culley L et al. (2013) The social and psychological impact of endometriosis on women's lives: a critical narrative review. Hum Reprod Update 19(6):625–639.
Marinho MCP, Magalhaes TF, Fernandes LFC, Augusto KL, Brilhante AVM, Bezerra LRPS (2018) Quality of life in women with endometriosis: an integrative review. J Women's Health (Larchmt) 27(3):399–408.
Mabrouk M, Raimondo D, Del Forno S, Baruffini F, Arena A, Benfenati A, Youssef A, Martelli V, Seracchioli R (2018) Evaluation of pelvic floor muscle in three- and four-dimensional transperineal ultrasonography in women with ovarian endometriosis with or without retroperitoneal infiltration: A step towards a complete functional assessment. Ultrasound Obstet Gynecol 52(2):265–268.
Arena A, Degli Esposti E, Cocchi L, Orsini B, Lenzi J, Del Forno S, Raimondo D, Youssef A, Seracchioli R (2022) Three-dimensional ultrasound evaluation of pelvic floor muscle contraction in women affected by deep infiltrative endometriosis: application of the rapid contraction scale. J Ultrasound Med 41(12):2973–2979.
Mabrouk M, Montanari G, Guerrini M, Villa G, Solfrini S, Vicenzi C, Mignemi G, Zannoni L, Frasca C, Di Donato N, Facchini C, Del Forno S, Geraci E, Ferrini G, Raimondo D, Alvisi S, Seracchioli R (2011) Does laparoscopic treatment of deep infiltrating endometriosis improve quality of life? A prospective study. Health Quality of Life Outcomes 6(9):98
Di Donato N et al (2014) Should women with endometriosis worry about sex? Eur J Obstet Gynecol Reprod Biol 179:69–74.
Bourdel N, Alves J, Pickering G, Ramilo I, Roman H, Canis M (2015) Systematic review of endometriosis pain assessment: How to choose a scale? Hum Reprod Update 21(1):136–152. 10.1093/humupd/dmu046
Jimenez JCV, Romero LL, Garcia IB, Sanchez ML, Fernandez RO (2023) Endometriosis and dyspareunia: solving the riddle. Eur J Obstet Gynecol Reprod Biol X 9(19):100224.
Rogers RG, Pauls RN, Thakar R, Morin M, Kuhn A, Petri E, Fatton B, Whitmore K, Kinsberg S, Lee J (2018) International Society of Urogynecology (IUGA)/International Continence Society (ICS) joint report on terminology for the assessment of the sexual health of women with pelvic floor dysfunction. Neurourol Urodyn 37:1220–1240
Mabrouk M et al. (2020) Painful love: Superficial dyspareunia and three-dimensional transperineal ultrasound evaluation of the pelvic floor muscle in women with endometriosis. J Sex Marital Ther 46(2):187–196. 10.1080/0092623X.2019.1676852
Yong PJ, Mui J, Allaire C, Williams C (2014) Pelvic floor tenderness in the etiology of superficial dyspareuninia. J Obstet Gynaecol Can 36(11):1002–1009.
Del Forno S et al (2021) Evaluation of the levator hiatal area using 3D/4D transperineal ultrasound in women with deep infiltrative endometriosis and superficial dyspareunia treated with pelvic floor muscle physiotherapy: randomized controlled trial. Ultrasound Obstet Gynecol 57(5):726–732.
Raimondo D, Youssef A, Mabrouk M, Del Forno S, Martelli V, Pilu G, Rizzo N, Zannoni L, Paradisi R, Seracchioli R (2017) Pelvic floor muscle dysfunction on 3D/4D transperineal ultrasound in patients with endometriosis with deep infiltration: a pilot study. Ultrasound Obstet Gynecol 50(4):527–532.
Yong PJ (2017) Deep dyspareunia in endometriosis: a proposed framework based on pain mechanisms and genito-pelvic pain penetration disorder. Sex Med Rev 5(4):495–507.
Yong PJ, Sadownik L, Brotto LA (2015) Simultaneous deep-superficial dyspareunia: prevalence, relationships and outcomes in a multidisciplinary vulvodynia program. J Sex Med 12(1):219–227.
Kaya S, Hermans L, Willems T, Roussel N, Meeus M (2013) Central susceptibility in urogynecologic chronic pelvic pain: a systematic literature review. Pain Physician 16:291–308
Malykhina AP (2007) Neural mechanisms of pelvic organ cross-sensitivity. Neuroscience 149:660–672
Raimondo D, Raffone A, Renzulli F, Sanna G, Raspollini A, Bertoldo L, Maletta M, Lenzi J, Rovero G, Travaglino A, Mollo A, Seracchioli R, Casadio P (2023) Prevalence and risk factors of central sensitivity in women with endometriosis. J Minim Invasive Gynecol 30(1):73-80.e1
Stratton P, Khachikyan I, Sinaii N, Ortiz R, Shah J (2015) Association of chronic pelvic pain and endometriosis with sensitivity and symptoms of myofascial pain. Obstet Gynecol 125(3):719–728
Yong PJ, Williams C, Bedaiwy MA, Allaire C. A proposed platform for phenotyping pain associated with endometriosis: unification of peripheral and central pain mechanisms. Curr Obstet Gynecol Rep. 2020; 9(3):89–97.
Morotti M, Vincent K, Brawn J, Zondervan KT, Becker CM. Peripheral changes in pain associated with endometriosis. Hum Reprod Update. 2014; 20(5):717–736.
Brawn J, Morotti M, Zondervan KT, Becker CM, Vincent K. Central changes associated with chronic pelvic pain and endometriosis. Hum Reprod Update. 2014; 20(5):737–747.
Nijs J, Lahousse A, Kapreli E, et al. Nosiplastic pain criteria or recognition of central sensitivity? Pain phenotyping in the past, present and future. J Clin Med. 2021;
Orr NL, Wahl KJ, Noga H, et al. Phenotyping of sexual pain in endometriosis using the central sensitivity inventory. J Sex Med. 2020; 17(4):761–770.
van Barneveld E, Manders J, van Osch FHM, et al. Depression, anxiety, and related factors in endometriosis: a systematic review and meta-analysis. Journal of Women's Health (Larchmt). 2022; 31(2):219–230.
Pfaus JG, Quintana GR, Mac Cionnaith C, Parada M. Whole versus the sum of some parts: Towards resolving the apparent contradiction between clitoral orgasm and vaginal orgasm. Socioaffect Neurosci Psychol. 2016; 6(1):32578.
Arias-Castillo L, Garcia L, Garcia-Perdomo HA. The complexity of the female orgasm and ejaculation. Arch Gynecol Obstet. 2023; 308(2):427–434.
Reinert AE, Simon JA. "Have you reached orgasm or are you just laughing at me?" Rare phenomena associated with orgasm . Sex Med Rev. 2017; 5(3):275–281.
Ding A, Noga H, Bouchard KN, Bedaiwy MA, Lee C, Allaire C, Orr NL, Yong PJ. Pain with orgasm in endometriosis: potential etiologic factors and clinical correlates. J Sex Med. 2024 Sep 3; 21(9):807-815. doi: 10.1093/jsxmed/qdae084. PMID: 39039031; PMCID: PMC11372072.
Orr NL, Noga H, Williams C, et al. Deep dyspareunia in endometriosis: the role of the bladder and pelvic floor. J Sex Med. 2018; 15(8):1158–1166.
Drossman DA, Dumitrascu DL. Rome III: the new standard for functional gastrointestinal disorders. J Gastrointestin Liver Dis. 2006; 15(3):237–241
Montenegro ML, Mateus-Vasconcelos EC, Rosa e Silva JC, Nogueira AA, Dos Reis FJ, Poli Neto OB. The importance of assessment of pelvic muscle tenderness in women with chronic pelvic pain. Pain Med. 2010; 11(2):224–228.
Wallace SL, Miller LD, Mishra K. Pelvic floor physiotherapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol. 2019; 31(6):485–493.
Lo L, Lamvu G, Alappattu M, Witzeman K, Markovic D, Rapkin A. Predictors of mucosal and myalgia pain in vulvodynia: a cross-sectional analysis from the National Vulvodynia Registry. J Pain. 2021; 22(2):161–170.
Yong PJ. Clinical conundrum: A 33-year-old woman with post-orgasm pain and a history of endometriosis. J Obstet Gynaecol Can. 2020; 42(5):625–628.
Levin R.J. Pharmacology of the human female orgasm—biological and physiological backgrounds. Pharmacol Biochem Behav. 2014; 121:62–70.
Komisaruk BR, del Cerro MCR, Goldstein I. Orgasm uses the pain pathway: Is orgasm "inevitable pain"? Sex Med Rev. 2023; 11(4):291–295.
Bishop LA. Management of chronic pelvic pain. Clin Obstet Gynecol. 2017;60(3):524–530. doi: 10.1097/GRF.0000000000000299
Muzii L, Di Tucci C, Achilli C, et al. Continuous versus cyclic oral contraceptives after laparoscopic excision of ovarian endometriomas: a systematic review and metaanalysis. Am J Obstet Gynecol. 2016;214(2):203–211. doi: 10.1016/j.ajog.2015.08.074 [DOI] [PubMed] [Google Scholar]
Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2015;30(7):CD001751
Yalçın Bahat, P., Yücel, B., Yuksel Ozgor, B., Kadiroğulları, P., Topbas Selçuki, N. F., Çakmak, K., & Üreyen Özdemir, E. (2022). The effect of dydrogesterone on sexual function in endometriosis. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology, 42(5), 1276–1279.
Caruso, S., Iraci, M., Cianci, S., Vitale, S. G., Fava, V., & Cianci, A. (2019). Effects of long-term treatment with Dienogest on the quality of life and sexual function of women affected by endometriosis-associated pelvic pain. Journal of pain research, 12, 2371–2378.
Nakamura M, Katsuki Y, Shibutani Y, Oikawa T. Dienogest, a synthetic steroid, suppresses both embryonic and tumor cell-induced angiogenesis. Eur J Pharmacol. 1999;386(1):33–40. doi: 10.1016/S0014-2999(99)00765-7
Marinho, M. C. P., Magalhaes, T. F., Fernandes, L. F. C., Augusto, K. L, Brilhante, A. V. M., Bezerra, L. R. P. S., “Quality of life in women with endometriosis: An integrative review”, Int. J. Womens Health (Larchmt)., 27 (3), 399-408, 2018. 48
Chaman-Ara, K., Bahrami, M. A, Bahrami, E., “Endometriosis psychological aspects: A literature review”, J. Endometr. Pelvic Pain Disord.,, 9 (2), 105-111, 2017.
Hickey, M., Ballard, K., Farquhar, C. “Endometriosis”, BMJ, 348: g1752, 2014.
Mehedintu, C., Plotogea M. N., Lonescu, S., Antonovici, M., “Endometriosis still a challenge”, J. Med. Life., 7 (3), 349-357, 2014.
Berker, B., Seval, M., “Problems with the diagnosis of endometriosis”, Womens Health (Lond)., 11 (5), 597-601, 2015.
Aşçı, Ö., Kocaöz, S., “Üreme organları tümörleri”, Hemşirelik ve Ebelik için Kadın Sağlığı ve Hastalıkları, Editör, Arslan Özkan, H., Akademisyen Kitapevi, Ankara, 673-720, 2019.
Ballard K. D., Seaman, H. E., de Vries, C. S., Wright, J. T., “Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control studyPart 1”, BJOG, 115 (11), 1382–1391, 2008
İnternet: World Health Organization “Endometriosis” https://www.who.int/newsroom/fact-sheets/detail/endometriosis
Vitale, S. G., La Rosa, V. L., Rapisarda, A. M. C., Laganà, A. S., “Impact of endometriosis on quality of life and psychological well-being”, J. Psychosom. Obstet. Gynaecol., 38 (4), 317-319, 2017.
Giudice LC (2010) Clinical practice. Endometri N Engl J Med 362(25):2389–2398.
Culley L et al. (2013) The social and psychological impact of endometriosis on women's lives: a critical narrative review. Hum Reprod Update 19(6):625–639.
Marinho MCP, Magalhaes TF, Fernandes LFC, Augusto KL, Brilhante AVM, Bezerra LRPS (2018) Quality of life in women with endometriosis: an integrative review. J Women's Health (Larchmt) 27(3):399–408.
Mabrouk M, Raimondo D, Del Forno S, Baruffini F, Arena A, Benfenati A, Youssef A, Martelli V, Seracchioli R (2018) Evaluation of pelvic floor muscle in three- and four-dimensional transperineal ultrasonography in women with ovarian endometriosis with or without retroperitoneal infiltration: A step towards a complete functional assessment. Ultrasound Obstet Gynecol 52(2):265–268.
Arena A, Degli Esposti E, Cocchi L, Orsini B, Lenzi J, Del Forno S, Raimondo D, Youssef A, Seracchioli R (2022) Three-dimensional ultrasound evaluation of pelvic floor muscle contraction in women affected by deep infiltrative endometriosis: application of the rapid contraction scale. J Ultrasound Med 41(12):2973–2979.
Mabrouk M, Montanari G, Guerrini M, Villa G, Solfrini S, Vicenzi C, Mignemi G, Zannoni L, Frasca C, Di Donato N, Facchini C, Del Forno S, Geraci E, Ferrini G, Raimondo D, Alvisi S, Seracchioli R (2011) Does laparoscopic treatment of deep infiltrating endometriosis improve quality of life? A prospective study. Health Quality of Life Outcomes 6(9):98
Di Donato N et al (2014) Should women with endometriosis worry about sex? Eur J Obstet Gynecol Reprod Biol 179:69–74.
Bourdel N, Alves J, Pickering G, Ramilo I, Roman H, Canis M (2015) Systematic review of endometriosis pain assessment: How to choose a scale? Hum Reprod Update 21(1):136–152. 10.1093/humupd/dmu046
Jimenez JCV, Romero LL, Garcia IB, Sanchez ML, Fernandez RO (2023) Endometriosis and dyspareunia: solving the riddle. Eur J Obstet Gynecol Reprod Biol X 9(19):100224.
Rogers RG, Pauls RN, Thakar R, Morin M, Kuhn A, Petri E, Fatton B, Whitmore K, Kinsberg S, Lee J (2018) International Society of Urogynecology (IUGA)/International Continence Society (ICS) joint report on terminology for the assessment of the sexual health of women with pelvic floor dysfunction. Neurourol Urodyn 37:1220–1240
Mabrouk M et al. (2020) Painful love: Superficial dyspareunia and three-dimensional transperineal ultrasound evaluation of the pelvic floor muscle in women with endometriosis. J Sex Marital Ther 46(2):187–196. 10.1080/0092623X.2019.1676852
Yong PJ, Mui J, Allaire C, Williams C (2014) Pelvic floor tenderness in the etiology of superficial dyspareuninia. J Obstet Gynaecol Can 36(11):1002–1009.
Del Forno S et al (2021) Evaluation of the levator hiatal area using 3D/4D transperineal ultrasound in women with deep infiltrative endometriosis and superficial dyspareunia treated with pelvic floor muscle physiotherapy: randomized controlled trial. Ultrasound Obstet Gynecol 57(5):726–732.
Raimondo D, Youssef A, Mabrouk M, Del Forno S, Martelli V, Pilu G, Rizzo N, Zannoni L, Paradisi R, Seracchioli R (2017) Pelvic floor muscle dysfunction on 3D/4D transperineal ultrasound in patients with endometriosis with deep infiltration: a pilot study. Ultrasound Obstet Gynecol 50(4):527–532.
Yong PJ (2017) Deep dyspareunia in endometriosis: a proposed framework based on pain mechanisms and genito-pelvic pain penetration disorder. Sex Med Rev 5(4):495–507.
Yong PJ, Sadownik L, Brotto LA (2015) Simultaneous deep-superficial dyspareunia: prevalence, relationships and outcomes in a multidisciplinary vulvodynia program. J Sex Med 12(1):219–227.
Kaya S, Hermans L, Willems T, Roussel N, Meeus M (2013) Central susceptibility in urogynecologic chronic pelvic pain: a systematic literature review. Pain Physician 16:291–308
Malykhina AP (2007) Neural mechanisms of pelvic organ cross-sensitivity. Neuroscience 149:660–672
Raimondo D, Raffone A, Renzulli F, Sanna G, Raspollini A, Bertoldo L, Maletta M, Lenzi J, Rovero G, Travaglino A, Mollo A, Seracchioli R, Casadio P (2023) Prevalence and risk factors of central sensitivity in women with endometriosis. J Minim Invasive Gynecol 30(1):73-80.e1
Stratton P, Khachikyan I, Sinaii N, Ortiz R, Shah J (2015) Association of chronic pelvic pain and endometriosis with sensitivity and symptoms of myofascial pain. Obstet Gynecol 125(3):719–728
Yong PJ, Williams C, Bedaiwy MA, Allaire C. A proposed platform for phenotyping pain associated with endometriosis: unification of peripheral and central pain mechanisms. Curr Obstet Gynecol Rep. 2020; 9(3):89–97.
Morotti M, Vincent K, Brawn J, Zondervan KT, Becker CM. Peripheral changes in pain associated with endometriosis. Hum Reprod Update. 2014; 20(5):717–736.
Brawn J, Morotti M, Zondervan KT, Becker CM, Vincent K. Central changes associated with chronic pelvic pain and endometriosis. Hum Reprod Update. 2014; 20(5):737–747.
Nijs J, Lahousse A, Kapreli E, et al. Nosiplastic pain criteria or recognition of central sensitivity? Pain phenotyping in the past, present and future. J Clin Med. 2021;
Orr NL, Wahl KJ, Noga H, et al. Phenotyping of sexual pain in endometriosis using the central sensitivity inventory. J Sex Med. 2020; 17(4):761–770.
van Barneveld E, Manders J, van Osch FHM, et al. Depression, anxiety, and related factors in endometriosis: a systematic review and meta-analysis. Journal of Women's Health (Larchmt). 2022; 31(2):219–230.
Pfaus JG, Quintana GR, Mac Cionnaith C, Parada M. Whole versus the sum of some parts: Towards resolving the apparent contradiction between clitoral orgasm and vaginal orgasm. Socioaffect Neurosci Psychol. 2016; 6(1):32578.
Arias-Castillo L, Garcia L, Garcia-Perdomo HA. The complexity of the female orgasm and ejaculation. Arch Gynecol Obstet. 2023; 308(2):427–434.
Reinert AE, Simon JA. "Have you reached orgasm or are you just laughing at me?" Rare phenomena associated with orgasm . Sex Med Rev. 2017; 5(3):275–281.
Ding A, Noga H, Bouchard KN, Bedaiwy MA, Lee C, Allaire C, Orr NL, Yong PJ. Pain with orgasm in endometriosis: potential etiologic factors and clinical correlates. J Sex Med. 2024 Sep 3; 21(9):807-815. doi: 10.1093/jsxmed/qdae084. PMID: 39039031; PMCID: PMC11372072.
Orr NL, Noga H, Williams C, et al. Deep dyspareunia in endometriosis: the role of the bladder and pelvic floor. J Sex Med. 2018; 15(8):1158–1166.
Drossman DA, Dumitrascu DL. Rome III: the new standard for functional gastrointestinal disorders. J Gastrointestin Liver Dis. 2006; 15(3):237–241
Montenegro ML, Mateus-Vasconcelos EC, Rosa e Silva JC, Nogueira AA, Dos Reis FJ, Poli Neto OB. The importance of assessment of pelvic muscle tenderness in women with chronic pelvic pain. Pain Med. 2010; 11(2):224–228.
Wallace SL, Miller LD, Mishra K. Pelvic floor physiotherapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol. 2019; 31(6):485–493.
Lo L, Lamvu G, Alappattu M, Witzeman K, Markovic D, Rapkin A. Predictors of mucosal and myalgia pain in vulvodynia: a cross-sectional analysis from the National Vulvodynia Registry. J Pain. 2021; 22(2):161–170.
Yong PJ. Clinical conundrum: A 33-year-old woman with post-orgasm pain and a history of endometriosis. J Obstet Gynaecol Can. 2020; 42(5):625–628.
Levin R.J. Pharmacology of the human female orgasm—biological and physiological backgrounds. Pharmacol Biochem Behav. 2014; 121:62–70.
Komisaruk BR, del Cerro MCR, Goldstein I. Orgasm uses the pain pathway: Is orgasm "inevitable pain"? Sex Med Rev. 2023; 11(4):291–295.
Bishop LA. Management of chronic pelvic pain. Clin Obstet Gynecol. 2017;60(3):524–530. doi: 10.1097/GRF.0000000000000299
Muzii L, Di Tucci C, Achilli C, et al. Continuous versus cyclic oral contraceptives after laparoscopic excision of ovarian endometriomas: a systematic review and metaanalysis. Am J Obstet Gynecol. 2016;214(2):203–211. doi: 10.1016/j.ajog.2015.08.074 [DOI] [PubMed] [Google Scholar]
Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2015;30(7):CD001751
Yalçın Bahat, P., Yücel, B., Yuksel Ozgor, B., Kadiroğulları, P., Topbas Selçuki, N. F., Çakmak, K., & Üreyen Özdemir, E. (2022). The effect of dydrogesterone on sexual function in endometriosis. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology, 42(5), 1276–1279.
Caruso, S., Iraci, M., Cianci, S., Vitale, S. G., Fava, V., & Cianci, A. (2019). Effects of long-term treatment with Dienogest on the quality of life and sexual function of women affected by endometriosis-associated pelvic pain. Journal of pain research, 12, 2371–2378.
Nakamura M, Katsuki Y, Shibutani Y, Oikawa T. Dienogest, a synthetic steroid, suppresses both embryonic and tumor cell-induced angiogenesis. Eur J Pharmacol. 1999;386(1):33–40. doi: 10.1016/S0014-2999(99)00765-7
Pages
163-168
Published
January 21, 2025
Copyright (c) 2025 Academician Publishing Book Portal
