Long-term treatment of endometriosis-related pain among women seeking hormonal contraception. (4th May 2022)

• Record Type: Journal Article
• Authors: Vannuccini, Silvia; Biagiotti, Chiara; Esposto, Maria Celeste; La Torre, Francesco; Clemenza, Sara; Orlandi, Gretha; Capezzuoli, Tommaso; Petraglia, Felice
• Is Part Of: Gynecological endocrinology. Volume 38:Number 5(2022)
• Page Start: 398
• Page End: 402
• Publication Date: 2022-05-04
• Subjects: Combined oral contraceptives -- contraception -- desogestrel -- endometriosis -- pain -- progestin-only pill; Endocrine gynecology -- Periodicals; Generative organs, Female -- Diseases -- Periodicals; 618.1
• DOI: 10.1080/09513590.2022.2047172
• Languages: English
• ISSNs: 0951-3590

Abstract

Abstract: Objective: To evaluate the different effects of a progestin-only contraceptive with desogestrel (DSG) vs combined oral contraceptives (COCs) for a first line long-term treatment of endometriosis-related pain among patients seeking hormonal contraception. Methods: An observational retrospective cohort study was conducted in collaboration with a local outpatient clinic for endometriosis among a group of nulliparous young women ( n = 216) with endometriosis-related pain and seeking contraception. The cohort was subdivided into a group ( n = 73) treated as first line by DSG and another group ( n = 75) treated by a COC. During the study, clinical symptoms, side effects and possible changes in OC type use were recorded. Results: No significant difference was found between the two groups in terms of clinical characteristics and pain scores before treatment. After 6 months both treatments were effective in reducing endometriosis-related pain, and those treated with DSG showed lower levels of dysmenorrhea, dyspareunia and nonmenstrual pelvic pain than COCs group ( p < .01). After 12 months, in DSG Group some patients (15%) switched from DSG to a COC for breakthrough bleeding, whereas in COC Group 48% of patients switched to another type of COC for reduced efficacy on pain and/or for side effects. After 3 years of OC treatment, in DSG Group 79% of patients maintained the same therapy, whereas in COC Group only 14% continued the same COC type, 37% switched to another COC and 47% to DSG. Conclusions: A progestin-only contraceptive with DSG is a valid option for long term management of endometriosis-related pain in patients seeking hormonal contraception.