Jornal Vascular Brasileiro
http://www.jvb.periodikos.com.br/article/doi/10.1590/1677-5449.202502401
Jornal Vascular Brasileiro
Review Article

Gestrinona, lipedema e os limites da extrapolação teórica na prática clínica: uma revisão narrativa crítica

Gestrinone, lipedema, and the limits of theoretical extrapolation in clinical practice: a critical narrative review

Marcelo Fernandes Lima

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Resumo

O lipedema é uma doença inflamatória crônica do tecido adiposo caracterizada por acúmulo desproporcional de gordura subcutânea, dor e equimoses espontâneas, que acomete predominantemente mulheres e impacta a qualidade de vida. Apesar do crescente reconhecimento da influência hormonal nessa doença, as opções terapêuticas baseadas em evidências permanecem limitadas. Recentemente, a gestrinona tem sido proposta como tratamento off-label, sendo fundamentada em hipóteses mecanicistas hormonais. Foi realizada uma revisão narrativa crítica da literatura, utilizando bases de dados internacionais, com o objetivo de identificar evidências clínicas ou farmacológicas que sustentassem seu uso no tratamento do lipedema. Não foram encontrados ensaios clínicos, estudos observacionais, séries de casos ou relatos de caso avaliando diretamente essa terapêutica. As propostas existentes baseiam-se exclusivamente em extrapolações teóricas, sem validação clínica. Assim, as evidências atuais não sustentam o uso da gestrinona no tratamento do lipedema, devendo seu uso ser considerado experimental até a realização de estudos clínicos adequadamente delineados.

Palavras-chave

lipedema; tecido adiposo; terapia hormonal; gestrinona; medicina baseada em evidências

Abstract

Lipedema is a chronic inflammatory disorder of adipose tissue that predominantly affects women and is characterized by disproportionate subcutaneous fat accumulation, pain, spontaneous bruising, and significantly impaired quality of life. Although hormonal influences on its pathophysiology have been increasingly recognized, evidence-based treatment options remain limited. Recently, gestrinone has been proposed as an off-label therapy based on hormonal mechanistic hypotheses. A critical narrative review of the literature was conducted using international databases to identify clinical or pharmacological evidence supporting its use in lipedema. No clinical trials, observational studies, case series, or case reports directly evaluating this therapy were identified. Existing proposals rely exclusively on theoretical extrapolations lacking clinical validation. Therefore, current evidence does not support the use of gestrinone in the treatment of lipedema, and its use should be considered experimental until adequately designed clinical studies are available.

Keywords

lipedema; adipose tissue; hormone therapy; gestrinone; evidence-based medicine

References

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Submitted date:
01/27/2026

Accepted date:
04/03/2026

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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