Progestagens and anti-progestagens for pain associated with endometriosis

Abstract

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; OR: Odds ratio; GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate.

Dienogest and deep infiltrating endometriosis: The remission of symptoms is not related to endometriosis nodule remission

“…The non-response of the lesions after treatment may be due to the structural feature of the DIE lesions that are described as being composed of large fiber components and a lower percentage of endometrial tissue [34]. We believe that is possible to assume that the improvement of pain symptoms may be related not only to the atrophy of ectopic endometrium, but mainly to the antiinflammatory action or regulatory immune attributed to dienogest [30,35].…”

Dienogest and deep infiltrating endometriosis: The remission of symptoms is not related to endometriosis nodule remission

“…The non-response of the lesions after treatment may be due to the structural feature of the DIE lesions that are described as being composed of large fiber components and a lower percentage of endometrial tissue [34]. We believe that is possible to assume that the improvement of pain symptoms may be related not only to the atrophy of ectopic endometrium, but mainly to the antiinflammatory action or regulatory immune attributed to dienogest [30,35].…”

Understanding Peritoneal Fluid Estrogen and Progesterone Concentrations Permits Individualization of Medical Treatment of Endometriosis-Associated Pain with Lower Doses, Especially in Adolescents Not Requiring Contraception

“…All medical hormonal therapies of endometriosis, OCs, progestogen monotherapy [ 66 , 67 , 68 ], and Gn-RH [ 69 ] agonists [ 70 ] or antagonists [ 71 ] inhibit ovulation and decrease ovarian steroid hormone secretion. The plasma concentrations of the administered ethinylestradiol and progestins are poorly documented.…”

Medical management of endometriosis

“…Oral progestins have been used for over 50 years for managing endometriosis. More than 10 RCTs investigating pain symptoms are published, although most placebo-controlled RCTs are now dated, and meta-analysis comparing oral progestins with other suppressive therapies has not demonstrated superiority of one over the other [ 11 ].…”

Dienogest and deep infiltrating endometriosis: The remission of symptoms is not related to endometriosis nodule remission

“…The non-response of the lesions after treatment may be due to the structural feature of the DIE lesions that are described as being composed of large fiber components and a lower percentage of endometrial tissue [34]. We believe that is possible to assume that the improvement of pain symptoms may be related not only to the atrophy of ectopic endometrium, but mainly to the antiinflammatory action or regulatory immune attributed to dienogest [30,35].…”

Understanding Peritoneal Fluid Estrogen and Progesterone Concentrations Permits Individualization of Medical Treatment of Endometriosis-Associated Pain with Lower Doses, Especially in Adolescents Not Requiring Contraception

“…All medical hormonal therapies of endometriosis, OCs, progestogen monotherapy [ 66 , 67 , 68 ], and Gn-RH [ 69 ] agonists [ 70 ] or antagonists [ 71 ] inhibit ovulation and decrease ovarian steroid hormone secretion. The plasma concentrations of the administered ethinylestradiol and progestins are poorly documented.…”

Medical management of endometriosis

“…Oral progestins have been used for over 50 years for managing endometriosis. More than 10 RCTs investigating pain symptoms are published, although most placebo-controlled RCTs are now dated, and meta-analysis comparing oral progestins with other suppressive therapies has not demonstrated superiority of one over the other [ 11 ].…”

Dienogest and deep infiltrating endometriosis: The remission of symptoms is not related to endometriosis nodule remission

“…The non-response of the lesions after treatment may be due to the structural feature of the DIE lesions that are described as being composed of large fiber components and a lower percentage of endometrial tissue [34]. We believe that is possible to assume that the improvement of pain symptoms may be related not only to the atrophy of ectopic endometrium, but mainly to the antiinflammatory action or regulatory immune attributed to dienogest [30,35].…”

Understanding Peritoneal Fluid Estrogen and Progesterone Concentrations Permits Individualization of Medical Treatment of Endometriosis-Associated Pain with Lower Doses, Especially in Adolescents Not Requiring Contraception

“…All medical hormonal therapies of endometriosis, OCs, progestogen monotherapy [ 66 , 67 , 68 ], and Gn-RH [ 69 ] agonists [ 70 ] or antagonists [ 71 ] inhibit ovulation and decrease ovarian steroid hormone secretion. The plasma concentrations of the administered ethinylestradiol and progestins are poorly documented.…”

Medical management of endometriosis

“…Oral progestins have been used for over 50 years for managing endometriosis. More than 10 RCTs investigating pain symptoms are published, although most placebo-controlled RCTs are now dated, and meta-analysis comparing oral progestins with other suppressive therapies has not demonstrated superiority of one over the other [ 11 ].…”