Oral contraceptives in the treatment of endometriosis
Sübutlu məlumatların xülasələri
29.06.2018 • Sonuncu dəyişiklik 29.06.2018
Editors
Combined oral contraceptives may be effective for pain associated with endometriosis.
A Cochrane review included 5 trials, of which 3 trials including with "?> a total of 404 subjects provided data for analysis. Compared with placebo, combined oral contraceptives (COC) improved self-reported pain: in dysmenorrhoea verbal rating scale (scale 0 to 3) mean difference (MD) -1.30 points, 95% CI -1.84 to -0.76; 1 RCT, n=96; in dysmenorrhoea visual analogue scale MD -23.68 points, 95% CI -28.75 to -18.62; 2 RCTs, n= 327, and a reduction in menstrual pain from baseline to the end of treatment (MD 2.10 points, 95% CI 1.38 to 2.82; 1 RCT, n=169). One underpowered unblinded trial compared COC with goserelin. At the end of treatment, the women in the goserelin group were amenorrhoeic. At 6 months' follow-up, there was no clear difference between the groups.
A topic in Clinical Evidence
summarizes the results of 2 additional RCTs. One RCT (n=102) found no difference between COC for 12 months vs COC for 4 months followed by gonadorelin analogues for 8 months. The third RCT found that medroxyprogesterone acetate 150 mg every 3 months was superior to COC plus danazole 50 mg daily for reducing dysmenorrhoea, but not for reducing dyspareunia or non-menstrual pain (CI not reported).
Comment: The quality of evidence is downgradedby study limitations (unclear allocation concealment and blinding, and pharmaceutical funding).
Ədəbiyyat
- Brown J, Crawford TJ, Datta S et al. Oral contraceptives for pain associated with endometriosis. Cochrane Database Syst Rev 2018;(5):CD001019.
Johnson N, Farquhar C. What are the effects of hormonal treatments given at diagnosis? Endometriosis. Clinical Evidence 2005;13:2329-2339.
Vercellini P, Trespidi L, Colombo A, Vendola N, Marchini M, Crosignani PG. A gonadotropin-releasing hormone agonist versus a low-dose oral contraceptive for pelvic pain associated with endometriosis. Fertil Steril 1993 Jul;60(1):75-9.