New therapeutic strategies for endometriosis
Endometriosis is a chronic inflammatory disease characterised by the presence of endometrial-like tissue outside the uterine cavity. It affects around 1 in 10 women and is present in approximately 33% of infertile women.
The main symptoms are usually associated with pain, such as dysmenorrhoea, dyspareunia, dysuria and dyschezia, as well as infertility. In recent years, new therapeutic options have been developed to improve the management of this condition and offer relief to affected women.
Conventional treatments for endometriosis
To date, medical treatments for endometriosis have focused on relieving pain and reducing the recurrence of lesions.
Conventional approaches include the use of non-steroidal anti-inflammatory drugs (NSAIDs), which act against cytokines and inflammatory factors involved in the development of the disease.
Hormonal treatments are also used to create states of pseudo-pregnancy, pseudo-menopause or chronic anovulation, with the aim of reducing pain and decreasing lesion recurrence. However, these hormonal treatments may interfere with ovulation and remain controversial in women who wish to conceive.
Advances in angiogenesis and inflammation
In recent years, significant progress has been made in understanding the underlying mechanisms of endometriosis, especially in relation to angiogenesis and inflammation.
Angiogenesis, the formation of new blood vessels, plays a crucial role in the growth and maintenance of endometriotic lesions. Therefore, reducing angiogenesis without interfering with the menstrual cycle may be an effective therapeutic strategy.
The role of VEGF endothelial growth factor
Vascular endothelial growth factor (VEGF) is a key molecule involved in the formation of new blood vessels, both in physiological and pathological conditions.
In endometriotic lesions, VEGF promotes angiogenesis and contributes to their growth and maintenance. It has also been found that VEGF is involved in the pathogenesis of pain by promoting the growth of sensory nerve fibres in endometriosis lesions.
New therapeutic options under study
In order to develop more specific and effective therapeutic options, research has been carried out on different molecules.
One promising approach is the use of dopaminergic agonists, which have been shown to reduce VEGF expression in both endometrial and endothelial cells.
One of the dopaminergic agonists studied is quinagolide, which has shown encouraging results in clinical studies. For example, a study published in 2011 evaluated nine women with endometriosis who received quinagolide for 12–16 weeks. A 69.5% reduction in the size of endometriotic lesions was observed, along with a decrease in VEGF expression, pro-inflammatory cytokines and plasminogen activator inhibitor-1 (PAI-1).
Additional clinical studies are currently underway to evaluate the effect of a quinagolide vaginal ring on the size of endometriomas and pain relief.
Another molecule of interest is pentoxifylline, a methylxanthine with anti-inflammatory and immunoregulatory properties. Pentoxifylline inhibits PAI-1 expression, producing an anti-angiogenic and fibrinolytic effect on endometriotic lesions.
Its use has been observed to improve fertility in women with endometriosis. In a study involving 60 women with stage I and II endometriosis, the group treated with pentoxifylline achieved a conception rate of 31% after one year of therapy, compared with 18.5% in the placebo group.
In addition to quinagolide and pentoxifylline, other molecules are being studied for their anti-inflammatory properties, such as resveratrol, alpha-lipoic acid and coenzyme Q10. These substances show potential to reduce inflammation associated with endometriosis and improve the quality of life of affected women.
Endometriosis, fertility and personalised treatment
Endometriosis is a disease that affects many women and can cause pain and infertility. Conventional treatments focus on relieving symptoms and reducing lesion recurrence.
However, significant advances have been made in understanding the mechanisms behind endometriosis, leading to the development of new therapeutic strategies.
Recent research has focused on angiogenesis and inflammation as therapeutic targets. Molecules such as quinagolide and pentoxifylline have shown promising effects in reducing the size of endometriotic lesions and improving fertility. Other substances with anti-inflammatory properties are also being studied.
Specialised care for endometriosis
If you have endometriosis and are looking for specialised treatment options, we invite you to contact our medical team, highly experienced in complex fertility cases.
At our centre, we have specialists in endometriosis who stay up to date with the latest advances in the field and can offer you a comprehensive and personalised approach on your path to motherhood.
You do not have to face this disease alone. We are by your side from the very first day.
