Progestogen-only contraceptive pill compared with combined oral contraceptive in the treatment of pain symptoms caused by endometriosis in patients with migraine without aura

Morotti, Matteo; Remorgida, Valentino; Venturini, Pier Luigi; Ferrero, Simone

doi:10.1016/j.ejogrb.2014.05.016

Cited by 60 publications

(81 citation statements)

References 32 publications

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“…Meta-analysis of all reported quality of life data was impeded by unavailability of post-treatment means and standard deviations in two studies (32,33), although improvements in headache-related quality of life were reportedly significant in these studies. Similarly, although all studies followed the International Headache Society guidelines in principle (22), there was inconsistency between studies in the computation of averaged outcomes (e.g.…”

Section: Overall Completeness and Applicability Of Evidencementioning

confidence: 98%

“…Details of the searching process and application of inclusion and exclusion criteria are shown in Figure 1. Characteristics of the four included studies (28,(31)(32)(33) are shown in Table 1. All studies reported pre-and post-treatment data for a desogestrel 75microgram/day POP.…”

Section: Included Studiesmentioning

confidence: 99%

“…All studies reported pre-and post-treatment data for a desogestrel 75microgram/day POP. Two of the included studies (32,33) additionally compared the POP to a COC (containing desogestrel 150 micrograms and ethinylestradiol 20 micrograms) after 90 and 180 days' treatment. Nappi et al (31) examined two different groups with MA, one with previous COC use and one without.…”

Section: Included Studiesmentioning

confidence: 99%

“…In both studies, there were no significant differences in baseline demographic characteristics between the POP and COC groups. Morotti et al (32) examined the effects of the desogestrel POP, compared to continuous use (i.e. with no pill-free interval) of the desogestrel-containing COC in women with MO.…”

Section: Effects Of Interventions: Desogestrel 75 Mcg/day Pop Vs a Dmentioning

confidence: 99%

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Effectiveness of the progestin-only pill for migraine treatment in women: A systematic review and meta-analysis

et al. 2017

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Background Migraine is highly prevalent in women (18%). Peak morbidity affects their most productive years, coinciding with peak fertility. Hormonal contraception is often tailored for migraine prevention. Estrogen-containing contraceptives may be contraindicated in women experiencing migraine with aura due to the risk of vascular events. While improvements in migraine with a progestin-only pill (POP), which inhibits ovulation are documented, the strength and quality of evidence has not been formally evaluated. Objectives To determine the effectiveness of progestin-only contraceptives for migraine treatment by systematic review and meta-analysis. Data sources and selection MEDLINE, EMBASE and Cochrane Libraries were searched (1980 to September 2016) for studies on progestin-only treatments for migraine. Studies in English on >4 non-menopausal women aged 18-50 with migraine diagnosed by formal criteria were included. Data extraction and analysis Data were quality-assessed using the GRADE system. A random effects model was used for pooled analyses. Results Pooled analyses of four studies demonstrated that desogestrel 75 mcg/day, POP significantly but modestly reduced the number of migraine attacks and migraine days. Reduced intensity and duration, reduced analgesic and triptan use were observed, along with improved headache-related quality of life. GRADE analysis indicated evidence was low to very low for each outcome measure. Adverse effects resulted in treatment cessation for <10% of participants. Two studies compared desogestrel POP to a combined oral contraceptive, demonstrating similar migraine outcomes for both treatments. Conclusions The desogestrel POP shows promise in improving migraine in women. Current evidence is observational and based on small samples of women using only one oral progestin-only formulation. Further randomized trials on additional progestin-only contraceptives are required to confirm their role in migraine management. Abstract Background: Migraine is highly prevalent in women (18%). Peak morbidity affects their most productive years, coinciding with peak fertility. Hormonal contraception is often tailored for migraine prevention. Estrogen-containing contraceptives may be contraindicated in women experiencing migraine with aura due to the risk of vascular events. While improvements in migraine with a progestin-only pill (POP), which inhibits ovulation are documented, the strength and quality of evidence has not been formally evaluated. Objectives: To determine the effectiveness of progestin-only contraceptives for migraine treatment by systematic review and meta-analysis. Data sources and selection: MEDLINE, EMBASE and Cochrane Libraries were searched (1980 to September 2016) for studies on progestin-only treatments for migraine. Studies in English on >4 non-menopausal women aged 18-50 with migraine diagnosed by formal criteria were included. Data extraction and analysis: Data were quality-assessed using the GRADE system. A random effects model was used for pooled analyses. R...

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Section: Overall Completeness and Applicability Of Evidencementioning

confidence: 98%

Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Effects Of Interventions: Desogestrel 75 Mcg/day Pop Vs a Dmentioning

confidence: 99%

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Effectiveness of the progestin-only pill for migraine treatment in women: A systematic review and meta-analysis

et al. 2017

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“…As untoward effects of OCs and progestins partly differ, a shift from the former to the latter compounds, or vice versa, could allow continuing treatment with a safe, effective, and inexpensive medication without the need for stepping up to a drug with a less favorable therapeutic profile or resorting to surgery. However, very limited information is available on what should a patient expect from these changes [17, 18]. The answers to these questions seem important, as the clinical issue is not rare and may interfere with health-related quality of life and disease management.…”

Section: Introductionmentioning

confidence: 99%

Shifting from Oral Contraceptives to Norethisterone Acetate, or Vice Versa, because of Drug Intolerance: Does the Change Benefit Women with Endometriosis?

Vercellini

Ottolini

Frattaruolo

et al. 2018

Gynecol Obstet Invest

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Background/Aims: Oral contraceptives (OC) and norethisterone acetate (NETA) are among first-line medical therapies for symptomatic endometriosis, but their use is sometimes associated with intolerable side effects. We investigated whether shifting from low-dose OC to NETA (2.5 mg/day), or vice versa, improved tolerability. Methods: Sixty-seven women willing to discontinue their treatment because of intolerable side effects despite good pain relief, were enrolled in a self-controlled study, and shifted from OC to NETA (n = 35) or from NETA to OC (n = 32). The main study outcome was satisfaction with treatment 12 months after the change. Tolerability, pain symptoms, health-related quality of life, psychological status, and sexual functioning were also evaluated. Results: After treatment change, good tolerability was reported by 37% of participants who shifted to NETA, and by 52% of those who shifted to OC. At 12-month assessment, 51% of women intolerant to OC were satisfied with NETA, and 65% of those intolerant to NETA were satisfied with OC (intention-to-treat analysis). Other study variables did not vary substantially. Conclusions: In selected endometriosis patients, shifting from OC to NETA, or vice versa, because of side effects, improved tolerability. Better results were observed when substituting NETA with OC rather than the other way round.

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Hormonal Therapy in Endometriosis and Adenomyosis: Progestins

Darıcı

Oral

2022

Endometriosis and Adenomyosis

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Progestogen-only contraceptive pill compared with combined oral contraceptive in the treatment of pain symptoms caused by endometriosis in patients with migraine without aura

Cited by 60 publications

References 32 publications

Effectiveness of the progestin-only pill for migraine treatment in women: A systematic review and meta-analysis

Effectiveness of the progestin-only pill for migraine treatment in women: A systematic review and meta-analysis

Shifting from Oral Contraceptives to Norethisterone Acetate, or Vice Versa, because of Drug Intolerance: Does the Change Benefit Women with Endometriosis?

Hormonal Therapy in Endometriosis and Adenomyosis: Progestins

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