Title: Tailored Treatment for Endometriosis According to Women’s Life Cycle
Subtitle: Paradigm Shift in Endometriosis Diagnosis and Treatment
Byline: By [Journalist Name]
Publication Date: [Insert Date]
The number of endometriosis patients in Korea has been steadily on the rise, increasing by approximately 70% over the past five years. This debilitating condition not only brings about abdominal pain, menstrual discomfort, and painful intercourse, but it also demands lifelong management. With a recurrence rate of 40-50% within five years after surgery, effective long-term treatment is crucial for enhancing women’s overall quality of life.
Fortunately, advancements in endometriosis diagnosis technology and drug treatment have paved the way for tailored treatment approaches based on women’s life cycles and personal preferences. This has revolutionized the diagnosis and treatment strategies adopted in the field.
To commemorate the 10th anniversary of the domestic launch of ‘Vizan (Dienogest),’ Bayer Korea’s Women’s Health Division organized the VISTA EMS FORUM on October 24th. The forum aimed to share the global paradigm shift in endometriosis diagnosis and the latest treatment options available. The event, titled “VISanne Treatment for All Pathways” was held both online and offline at the Grand InterContinental Seoul Parnas.
Professor Lee Jeong-ryeol from Seoul National University chaired the forum, while Professor Kyung-wook Lee from Korea Medical University shared key insights into the latest global guideline changes and significant clinical data on endometriosis diagnosis and treatment. Professor Lee Da-yong from Boramae Hospital and Professor Song Jae-yeon from the Catholic University of Korea shed light on the characteristics of endometriosis throughout a woman’s life cycle, from puberty to pre- and post-menopause, and presented corresponding treatment strategies.
During the forum, Professor Kyung-Wook Lee emphasized the importance of early diagnosis in improving the quality of life for endometriosis patients. Astonishingly, it takes an average of 7 to 10 years from the onset of symptoms to receive an accurate diagnosis. However, recent advancements in clinical diagnosis methods using examination findings and imaging tests, such as ultrasound, have proven to be highly effective in diagnosing different types of endometriosis. This allows women with suspicious symptoms to receive prompt medical attention and expedite their path to treatment.
Traditionally, surgical treatment was the primary approach for endometriosis patients. However, newer drug treatments, such as Bizan, have demonstrated their efficacy in preventing symptom recurrence and controlling the progression of the disease. Notably, these medications can be taken long-term, ensuring patient safety even beyond surgical intervention.
Bizan, which contains dienogest, has emerged as a recommended first-line treatment option for endometriosis. Multiple global clinical studies have confirmed its long-term effectiveness and safety across all age groups, starting from puberty after menarche. In over 80% of patients, Bizan significantly alleviated endometriosis-associated pelvic pain and improved health-related quality of life.
These developments have influenced both domestic and international endometriosis diagnosis and treatment guidelines. The European Society for Reproductive Medicine (ESHRE) and the UK’s National Institute for Health and Care Excellence (NICE) advocate prioritizing drug treatment over surgery for endometriosis management. Moreover, they emphasize the importance of personalized, patient-centered management for optimal treatment outcomes. Reflecting this shift, the Korean Endometriosis Society also revised its clinical practice guidelines in 2022, recommending long-term drug treatment as the initial approach, except for certain high-risk groups that may require MRI for diagnosis and immediate surgical intervention.
Taking into account women’s life cycles, the second session of the VISTA EMS Forum focused on diagnosis and treatment strategies for endometriosis from puberty to menopause. Adolescent girls often experience menstrual pain, making it challenging to diagnose endometriosis based solely on pain symptoms. However, as the age of menarche decreases, the incidence of endometriosis among young individuals has increased. Early diagnosis and treatment are crucial in preventing the progression of the disease into a chronic condition.
Professor Song Jae-yeon from the Catholic University of Korea highlighted the importance of conducting a comprehensive investigation when chronic or intermittent pelvic pain, dysmenorrhea, nausea, or urinary difficulties arise during puberty. He emphasized that oral contraceptives or progestogen drugs, such as Vizan, are recommended as first-line treatments for teenage girls diagnosed with endometriosis.
Notably, separate clinical studies have reinforced the efficacy of Vizan in treating adolescent endometriosis, resembling its effectiveness in adults. These studies involving 111 endometriosis patients aged 12 and older demonstrated the significant pain reduction and preservation of ovarian reserve during Bizan treatment. Moreover, it was found that the decrease in bone mineral density witnessed during treatment was reversed within six months after discontinuation, alleviating concerns about long-term effects.
Furthermore, endometriosis symptoms can persist even after menopause. Research has shown a high prevalence of advanced endometriosis in the perimenopausal age group, necessitating a careful consideration of the risk of endometriosis in patients experiencing unexplained pelvic pain prior to and after menopause. The European Society of Reproductive Medicine recommends surgical therapy as the primary treatment option for postmenopausal women. However, if surgery is not feasible or symptoms persist or recur after surgery, drug therapy is recommended for long-term management.
When treating endometriosis in women of childbearing age, the potential impact on future pregnancy plans is a crucial factor to consider. Endometriosis itself poses risks to fertility and ovarian function. Furthermore, repeated surgeries can further impair ovarian function. Hence, a cautious surgical approach is essential.
Professor Lee Da-yong from Boramae Hospital emphasized the need for long-term management plans tailored to each patient’s characteristics, especially for those who do not intend to conceive immediately. Such plans should prioritize preserving ovarian function and assess the risk of reduced residual ovarian function and future infertility. Effective counseling on fertility preservation treatments should be provided accordingly.
It is worth noting that endometriosis is most prevalent among women aged 30 to 39 who desire to have children.
Since its approval in Korea in 2011, Bizan has been utilized in the treatment of endometriosis diagnosed through laparoscopy, ultrasound, or magnetic resonance imaging (MRI). It effectively reduces pelvic pain caused by endometriosis by inhibiting the growth-promoting effects of estrogen on the endometrium.
In conclusion, the VISTA EMS FORUM served as a platform to share significant advancements in endometriosis diagnosis and treatment. Tailored treatment approaches that consider women’s life cycles provide a new paradigm for tackling this debilitating condition. Early diagnosis and personalized long-term management not only alleviate symptoms but also enhance the overall well-being and quality of life for endometriosis patients.
Tailored treatment is needed for each female life cycle from puberty to pre- and post-menopause.
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Professor Kyungwook Lee from Korea University. [사진=바이엘 코리아]
The number of endometriosis patients in Korea is gradually increasing. It has increased by around 70% in the last five years. Endometriosis not only affects women’s overall quality of life by causing abdominal pain, menstrual pain, and dyspareunia, but also requires lifelong management as the recurrence rate within 5 years after surgery is high at 40-50 %.
Currently, with the development of endometriosis diagnosis technology and drug treatment, long-term tailored treatment based on women’s life cycle and personal preferences is becoming possible, changing the paradigm of diagnosis and treatment strategies.
On the 24th, Bayer Korea’s Women’s Health Division held the VISTA EMS FORUM (VISTA EMS FORUM) to share the global paradigm shift in endometriosis diagnosis and the latest treatment to commemorate the 10th anniversary of the domestic launch of ‘Vizan (ingredient name: Dienogest) ‘ at the Grand InterContinental Seoul Parnas VISanne Treatment for All Pathways was held from the EndoMetrioSis Patient Forum). The event was held simultaneously online and offline.
This forum was chaired by Professor Lee Jeong-ryeol of Seoul National University, and Professor Kyung-wook Lee of Korea Medical University shared the latest global guideline changes and major clinical data on the diagnosis and treatment of endometriosis through a presentation on ‘Current of Bijan’ , and Boramae Hospital Professor Lee Da-yong and Professor Song Jae-yeon from the Catholic University of Korea presented on the characteristics of endometriosis disease according to the life cycle of women from puberty to menopause before and after menopause and r corresponding treatment strategies through the ‘Bijan, the next 10-year session.
Professor Kyung-Wook Lee of Korea University School of Medicine, who was the first speaker, presented changes in the endometriosis diagnosis environment. According to this, early diagnosis is more important than anything else to improve the quality of life of endometriosis patients. However, the survey results showed that it takes an average of 7 to 10 years from the first appearance of symptoms to be diagnosed with endometriosis.
Professor Lee said, “Until a few years ago, laparoscopy was essential for confirming the diagnosis, but now major domestic and international guidelines also recommend clinical diagnosis using examination findings and imaging tests,” adding, ” Ultrasound is a very diagnostic test for different types of endometriosis.” “Because it provides accuracy, women visiting the hospital with suspicious symptoms will be able to receive medical treatment and ultrasound examinations, shortening the time between diagnosis and the start of treatment.”
He continued, “Until now, the common method of treating endometriosis was to perform surgical treatment after confirming the diagnosis through laparoscopy,” and added, “Recent drug treatments such as Bizan have the effect of preventing and controlling the recurrence of endometriosis symptoms and lesions. , and are safe even when taken long term As this has been proven, drug treatment can be prioritized considering the patient’s symptoms and pregnancy plan. He also emphasized that long-term drug treatment is recommended even after surgical treatment.
Vizan is a drug treatment option containing dienogest, which is recommended as a first-line treatment for endometriosis. Through multiple global clinical studies, the long-term efficacy and safety profile was confirmed in endometriosis patients of all ages, from puberty after menarche.
The results of the study showed that Vizan improved endometriosis-associated pelvic pain (EAPP) and improved health-related quality of life (HRQoL) in more than 80% of patients. In another study, Bizan was confirmed to be a stable treatment option as there was no difference in safety compared to short-term treatment even during long-term treatment of more than 15 months.
Domestic and international endometriosis diagnosis and treatment guidelines also reflect this paradigm shift. The European Society for Reproductive Medicine (ESHRE) and the UK’s National Institute for Health and Care Excellence (NICE) advise that drug treatment, not surgery, should be the primary treatment for the management of endometriosis, and that management should be individualized patient-centredness is important to optimal treatment. The Korean Endometriosis Society also revised its clinical practice guidelines in 2022 and recommended long-term drug treatment first, except for some high-risk groups that require MRI for diagnosis and immediate surgery for treatment.
From left, Professor Lee Da-yong from Boramae Hospital and Professor Song Jae-yeon from the Catholic University of Korea. [사진=바이엘 코리아]The second session included a presentation on diagnosis and treatment strategies for endometriosis according to the life cycle of women from puberty to menopause.
As menstrual pain is very common in adolescence, it is difficult to lead to a diagnosis based on pain alone, and the period until a diagnosis is reported to be approximately 2 to 3 times longer than in adults. However, as the age of menarche decreases, the incidence of endometriosis among young people increases, and if not treated in time, it can worsen and become a chronic disease, so early diagnosis and treatment are equally important.
Professor Song Jae-yeon of the Catholic University of Korea said, “If symptoms such as chronic or intermittent pelvic pain, dysmenorrhea, nausea, or urinary difficulties appear in puberty, they need to be carefully investigated.” He added, “Even if a teenage girl is diagnosed with endometriosis, oral contraceptives or oral contraceptives are required according to the guidelines “Treatment with progestogen drugs such as Vizan is recommended as a first-line treatment,” he said. .
According to the data shared by Professor Song, Vizan’s effectiveness in treating adolescent endometriosis confirmed through a separate clinical study was similar to that found in adults. As a result of a study carried out on the efficacy and safety of Vizan in 111 endometriosis patients aged 12 years or older and younger than 18, it was confirmed that pain associated with endometriosis in adolescent patients was significantly reduced during treatment Bizan, and the retention effect of ovarian reserve was found and the safety profile has also been tested.
Professor Song added, “Bone mineral density (BMD) decreased by about 1.2% at 48 weeks of treatment, but was confirmed to improve 6 months after the end of treatment, so it was not a level of concern.”
Symptoms of endometriosis can appear even after menopause. In particular, studies have shown that the rate of advanced endometriosis (stages 3 and 4) is high in the perimenopausal age group, suggesting that the risk of endometriosis needs to be considered in patients with unclear pelvic pain before and after menopause.
The guidelines of the European Society of Reproductive Medicine recommend surgical therapy as the first treatment option in the treatment of endometriosis in postmenopausal women, and if surgery is not possible or if symptoms persist or return after surgery, management is recommended. by drug therapy after surgery.
When treating endometriosis in women of childbearing age, it is important to consider future pregnancy plans. Endometriosis itself poses a risk of infertility or impaired ovarian function. Repeated surgery also affects ovarian function, so a more careful approach to surgery is required.
Professor Lee Da-yong from Boramae Hospital said, “Endometriosis is a disease that requires long-term management, and a treatment plan tailored to individual characteristics is required. they don’t intend to get pregnant right away.” “Treatment is needed to preserve ovarian function, and the risk of reduced residual ovarian function and future infertility should be carefully assessed, and appropriate counseling should be provided regarding fertility preservation treatment,” he explained.
In this regard, it was found that domestic endometriosis disease had the highest prevalence among women between the ages of 30 and 39 to have children.
Meanwhile, Bizan was approved in Korea for the treatment of endometriosis in 2011, and is used for patients diagnosed with endometriosis by laparoscopy, ultrasound or magnetic resonance imaging (MRI) who have endometriosis in the ovaries, rectum , or the bladder. , salary applies. This treatment is an oral medication that helps reduce pelvic pain experienced by women with endometriosis by reducing the effect of estrogen growth on the endometrium.
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