#397 ‒ Endometriosis and adenomyosis: diagnosis, fertility, reproductive aging, and emerging treatments | Renato Tomioka, M.D., Ph.D.

“you can start with a pill, a progestin only pill. Okay. Like Norethindrone or Dienogest or Desogestrel. Or you can use the combined contriceptive pill”

“So we could use a combined pill or a progestin. In Brazil, we have this Dienogest, which is a very good progestin for endometriosis. In the US we have the Natazia. Natazia is like estrogen.”

“Nowadays, we have the antagonists, the oral antagonists in the US, they are very expensive. They are called Elagolix and Relugolix, but they are oral medications.”

“Second layer is the so-called nociplastic pain, where the nerves are infiltrated by the lesions and they can have burning sensations, sometimes on their legs and the back. And here medications can help, sometimes Gabapentin and SNRIs, right? Surgery can remove. Some of those lesions, we do this technique called nerve sparing.”

“We prefer, like we have much more data with analogs, the agonists, Lupron, it's called the Goserelin, they are injectable, subcutaneously, monthly, right?”

“there's one molecule called HMI-115. It's a monoclonal antibody that targets the receptor of prolactin.”

“because those patients, they usually are not trying to conceive, so they want contraception, right? And if the patient doesn't have endometrioma, we can use an IUD, like a Mirena or a Kyleena. In addition to an oral contraceptive? No, just we tend to use just one.”

“Female pain, especially. So they are told that, oh, that's normal. Just have a medication, have an anti-inflammatory and go. But some teenagers, they just can't go to school. They miss school. Sometimes they miss work.”