Postoperative Depot Medroxyprogesterone Acetate versus Continuous Oral Contraceptive Pills in the Treatment of Endometriosis-Associated Pain: A Randomized Comparative Trial

Abstract

Background/Aim: To evaluate the efficacy and tolerability of postoperative depot medroxyprogesterone acetate (DMPA) versus postoperative continuous oral contraceptive (OC) pills in the treatment of endometriosis-associated pain. Methods: After a conservative surgery, 84 patients with symptomatic endometriosis were randomized to receive either intramuscular DMPA (150 mg) every 12 weeks for 24 weeks or continuous OC pills (ethinyl estradiol 0.03 mg and gestodene 0.075 mg) daily for 24 weeks. At weeks 12 and 24 of the treatment phase, patients rated their satisfaction with treatment and reported pain improvement and adverse effects. Results: There was no significant difference in the percentages of patients who reported satisfaction between the DMPA group and the OC group at weeks 12 and 24 (92.9 vs. 90.5%, and 92.9 vs. 88.1%, respectively). The rates of withdrawal because of persistent pain or side effects in the two groups were similar. Pain scores improved significantly in both groups, but dysmenorrhea scores on a visual analog scale at week 24 were significantly higher in the OC group than in the DMPA group (p = 0.039). Conclusion: Both postoperative DMPA and postoperative OC pills for 24 weeks were found to be effective and acceptable options for treating endometriosis-associated pain.

Reproductive Performance after Surgery for Endometriosis: Predictive Value of the Revised American Fertility Society Classification and the Endometriosis Fertility Index

“…Early observational studies suggest that in women with stage III/IV endometriosis without other identifiable infertility factors, conservative surgical treatment with laparoscopy and possibly laparotomy increases fertility [11,12]. Postoperative medical treatment has been used to release endometriosis-associated pain, suppress disease development and prevent recurrence [13], but it does not improve natural PRs. A meta-analysis of 12 studies comparing surgery plus hormonal treatment versus surgery plus placebo or no treatment showed no difference in PRs [14], which is consistent with our study results (data not shown).…”

Human Chorionic Gonadotropin Improves Endometriosis Through Downregulation of Leptin Expression in Rats

“…Some are aimed at imitating periods during which a woman menopauses, example for GnRH analogues or danazol. Some are in light of mimic periods in which a woman is pregnant, such as oral contraceptives or progestins [22,23,24]. The others are directed against endometriotic estrogen synthesis [25], including Anastrozole and letrozole [26,27].…”

Can Extracorporeal Magnetic Innervation Be a Treatment Modality for Primary Dysmenorrhea

“…nausea, headaches, depression, weight gain, thromboembolism) might limit the usage of these drugs [1,2,3,4,5]. …”

“…Dysmenorrhea also has a negative impact on quality of life [2,3,4]. Primary dysmenorrhea is not associated with any identifiable pelvic disease.…”