Pharmacotherapy of Endometriosis

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 2936

Special Issue Editors


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Guest Editor
Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Busan, Republic of Korea
Interests: endometriosis; dysmenorrhea; infertility; postpartum; Korean medicine

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Guest Editor
Department of Obstetrics and Gynecology, College of Korean Medicine, Dong Guk University, 27, Dongguk-ro, Ilsandong-gu, Goyang-si 10326, Gyeonggi-do, Republic of Korea
Interests: endometriosis; dysmenorrhea; infertility; menopausal disorders; Korean medicine

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Guest Editor
Department of Policy Development, National Institute of Korean Medicine Development, Seoul, Republic of Korea
Interests: endometriosis; infertility; pain management; herbal medicines; pharmacopuncture (herbal acupuncture)
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Special Issue Information

Dear Colleagues,

Endometriosis is a chronic condition that significantly impacts the quality of life for many women, causing pelvic pain, infertility, and other health complications. Pharmacotherapy remains one of the primary treatment approaches, aiming to manage symptoms and slow disease progression. In recent years, there has been growing interest in exploring integrative treatments, which may offer novel approaches through the use of herbal-based pharmacological interventions.

This Special Issue focuses on the pharmacotherapy of endometriosis, with a particular emphasis on the role of herbal medicine. We welcome submissions of original research, including preclinical studies, clinical trials, and review articles that investigate the efficacy, safety, and mechanisms of these treatments. Studies exploring plant-based compounds, herbal formulations, and integrative therapies involving pharmacopuncture are particularly encouraged, as they may offer innovative strategies for managing endometriosis symptoms.

By concentrating on pharmacotherapy, this Special Issue aims to bridge modern medical practices with traditional and complementary and alternative approaches, providing an insight into the potential of herbal-based treatments as part of the broader pharmacological management of endometriosis.

We look forward to receiving your contributions, which will help advance research in this important field.

Dr. Jang-Kyung Park
Dr. Dong Il Kim
Dr. Soo-Hyun Sung
Guest Editors

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Keywords

  • endometriosis
  • pharmacotherapy
  • integrative medicine
  • herbal medicine herbal formulations
  • plant-based compounds
  • herbal extracts
  • pharmacopuncture
  • pelvic pain
  • infertility

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Published Papers (3 papers)

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Review

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24 pages, 2839 KiB  
Review
Warburg-like Metabolic Reprogramming in Endometriosis: From Molecular Mechanisms to Therapeutic Approaches
by Bo-Sung Kim, Bosung Kim, Seyeong Yoon, Wonyoung Park, Sung-Jin Bae, Jongkil Joo, Wonnam Kim and Ki-Tae Ha
Pharmaceuticals 2025, 18(6), 813; https://doi.org/10.3390/ph18060813 - 28 May 2025
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Abstract
Endometriosis is a chronic gynecological disorder characterized by the presence of endometrial-like tissue outside the uterus, leading to inflammation, pain, and infertility. Emerging evidence indicates that endometriotic lesions exhibit cancer-like properties, including metabolic reprogramming marked by increased glucose uptake, enhanced Warburg’s effect, and [...] Read more.
Endometriosis is a chronic gynecological disorder characterized by the presence of endometrial-like tissue outside the uterus, leading to inflammation, pain, and infertility. Emerging evidence indicates that endometriotic lesions exhibit cancer-like properties, including metabolic reprogramming marked by increased glucose uptake, enhanced Warburg’s effect, and altered mitochondrial function. These metabolic adaptations support cell survival under hypoxic conditions and contribute to immune evasion and sustained proliferation. This review summarizes current findings on the molecular mechanisms driving metabolic reprogramming in endometriosis, including the roles of mitochondrial dysfunction, hypoxia-inducible factor (HIF) signaling, the PI3K/AKT/mTOR pathway, inflammatory cytokines, and genetic and epigenetic regulators. In addition, we discuss therapeutic strategies targeting glycolytic pathways using both synthetic inhibitors and natural compounds, which represent promising non-hormonal options. Finally, we highlight the need for further preclinical and clinical studies to validate metabolic interventions and improve outcomes for patients with endometriosis. Full article
(This article belongs to the Special Issue Pharmacotherapy of Endometriosis)
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17 pages, 294 KiB  
Review
Hormonal Treatment of Endometriosis: A Narrative Review
by Elvin Piriyev, Sven Schiermeier and Thomas Römer
Pharmaceuticals 2025, 18(4), 588; https://doi.org/10.3390/ph18040588 - 17 Apr 2025
Viewed by 1626
Abstract
Background: Endometriosis is one of the most common gynecological diseases, affecting up to 10–15% of women of reproductive age. It is a chronic, estrogen-dependent condition that often presents with heterogeneous symptoms, complicating diagnosis and delaying treatment. Methods: This is a narrative [...] Read more.
Background: Endometriosis is one of the most common gynecological diseases, affecting up to 10–15% of women of reproductive age. It is a chronic, estrogen-dependent condition that often presents with heterogeneous symptoms, complicating diagnosis and delaying treatment. Methods: This is a narrative review based on a comprehensive analysis of recent literature regarding hormonal treatment options for endometriosis, including primary and adjuvant therapies. Results: Combined oral contraceptives (COCs) are effective in reducing dysmenorrhea, but show limited benefit for other symptoms and may not prevent disease progression. Progestins, particularly dienogest, demonstrate superior long-term efficacy with favorable side-effect profiles. GnRH agonists and antagonists are reserved for second-line treatment due to side effects and hypoestrogenism, but can significantly reduce endometriotic lesions. The levonorgestrel intrauterine system (LNG-IUS) is especially effective in patients with adenomyosis. Conclusions: Hormonal therapies are central to the management of endometriosis. Progestins are considered the most suitable long-term option. Despite promising results, evidence quality varies, and further studies are needed to establish long-term efficacy, patient-specific outcomes, and direct comparisons between agents. Full article
(This article belongs to the Special Issue Pharmacotherapy of Endometriosis)

Other

Jump to: Review

23 pages, 1615 KiB  
Systematic Review
The Efficacy and Safety Herbal Medicine for Symptom Management After HIFU Treatment in Adenomyosis: A Systematic Review and Meta-Analysis
by Eun-Jin Kim, Young-Shin Shim, Hyun-Kyung Sung and Sang-Yeon Min
Pharmaceuticals 2025, 18(6), 843; https://doi.org/10.3390/ph18060843 - 4 Jun 2025
Viewed by 458
Abstract
Background/Objectives: Adenomyosis (AM) is a hormone-dependent gynecological disorder that negatively impacts the quality of life and fertility of reproductive-age women. This study aimed to evaluate the effectiveness of herbal medicine (HM) as a post-treatment strategy following high-intensity focused ultrasound (HIFU) therapy. Methods: [...] Read more.
Background/Objectives: Adenomyosis (AM) is a hormone-dependent gynecological disorder that negatively impacts the quality of life and fertility of reproductive-age women. This study aimed to evaluate the effectiveness of herbal medicine (HM) as a post-treatment strategy following high-intensity focused ultrasound (HIFU) therapy. Methods: English, Chinese, and Korean databases were systematically searched up to 24 March 2025. Eligible randomized controlled trials (RCTs) compared HM administration after HIFU therapy with HIFU therapy alone. Statistical analyses included mean difference (MD), standardized mean difference (SMD), and risk ratio (RR) with 95% confidence intervals (CIs). Evidence quality was assessed using GRADE approach. The protocol was registered with INPLASY (No.: INPLASY202530088). Results: Fourteen RCTs involving 1259 patients were included in the review. HM administration after HIFU therapy showed superior efficacy over HIFU therapy alone in reducing uterine volume (MD = −11.84, 95% CI: −13.74 to −9.95; p < 0.00001), adenomyotic lesion volume (MD = −2.86, 95% CI: −3.29 to −2.43; p < 0.00001), serum CA125 levels (SMD = −1.49, 95% CI: −2.41 to −0.58; p < 0.00001), serum estradiol (E2) levels (SMD = −1.28, 95% CI: −1.54 to −1.03; p < 0.0001), and improvements in dysmenorrhea (MD = −0.54, 95% CI: −1.06 to −0.02; p < 0.00001) Conclusions: HM may be an effective and safe adjunct to HIFU for managing AM. However, further high-quality RCTs with long-term follow-up are needed to validate these findings. Full article
(This article belongs to the Special Issue Pharmacotherapy of Endometriosis)
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