Bazedoxifene-Conjugated Estrogens for Treating Endometriosis

BACKGROUND: Endometriosis is a gynecologic disorder affecting 6-10% of reproductive-aged women. First-line therapies are progestin-based regimens; however, failure rates are high, often requiring alternative hormonal agents, each with unfavorable side effects. Bazedoxifene with conjugated estrogens is approved for treatment of menopausal symptoms, and use in animal studies has demonstrated regression of endometriotic lesions. As such, it represents a potential treatment option for endometriosis. CASE: A patient with stage III endometriosis referred for management of dysmenorrhea and cyclic pelvic pain was treated with 20 mg bazedoxifene and 0.45 mg conjugated estrogens daily for more than 6 months. She noted resolution of pelvic pain. There were no abnormal effects on hormonal, uterine, or ovarian parameters. CONCLUSION: Bazedoxifene with conjugated estrogens may be an effective alternative to traditional endometriosis treatment options.