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Hormonal treatments enables effective pain control in 80–90% of women with symptomatic endometriosis who also requires contraception.
Combined hormonal contraceptives (CHCs) and Progestin-only contraceptives (POCs) provides significant efficacy in alleviating endometriosis-associated pelvic pain, dyspareunia, dysmenorrhoea with an improvement of the quality of life (QoL), apparent from a systematic review published in the European Journal of Contraception & Reproductive Health Care. This review was conducted to evaluate the efficacy of hormonal contraceptives in decreasing disease-related pain and the postoperative risk of disease recurrence within people suffered from endometriosis.
Embase, Medline and PubMed searched to selected English language studies on hormonal contraceptive therapies (combined oral contraceptives [COCs], progestin-only contraceptives [POCs], combined hormonal contraceptives [CHCs], and progestin-only pills [POPs]) compared with placebo, other hormonal therapies, and comparator therapies. Postoperative rate of disease recurrence, endometriosis-related pain, and quality of life were considered as the main outcomes of the analysis.
POC and CHC medications provided clinically notable drop in dysmenorrhoea, coincided with alleviations in dyspareunia, non-cyclical pelvic pain, and improved QoL. Regarding COC medications, only flexible ethinylestradiol [EE]/drospirenone, and EE/norethisterone acetate [NETA] associated with enhanced efficacy than placebo and only there studies obtained the postoperative use of COCs for decreasing the risk of disease recurrence. No evidence regarding the reduced risk of disease recurrence was found for POCs.
Both POC and CHC exerts a significant efficacy in reducing dyspareunia, dysmenorrhea and pain, but the risk of disease recurrence only reduced by COC, not POC. Future analysis is required to reach definitive conclusions regarding the overall preponderance of any particular hormonal contraceptive.
The European Journal of Contraception & Reproductive Health Care
Hormonal contraception in women with endometriosis: a systematic review.
Giovanni Grandi et al.
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