A comparison of two different oral contraceptives in patients with severe primary dysmenorrhoea

Abstract

Pain relief of two different oral contraceptive pills (OCPs) in severe primary dysmenorrhoea (PD) was compared. Sixty-six nulliparous patients with severe PD requiring contraception were evaluated. Group 1 comprised 33 healthy controls. Patients with severe PD were divided into two groups. Patients in Group 2 were administered oestradiol valerate/dienogest and patients in Group 3 were administered ethinylestradiol/drospirenone. Doppler indices of both uterine arteries (left and right) including systolic/diastolicrates (S/D), pulsatility index (PI) and resistance index (RI) were measured, and a visual analogue scale (VAS) was applied to patients before treatment. VAS scores and Doppler indices were repeated after 3 months of OCP treatment and the changes in values were compared. The demographic and clinical characteristics of the patients were similar. The mean value of RI was significantly lower after therapy in Groups 2 and 3 in the right and left uterine arteries (p = .001 and p = .039, respectively). The clinical trial number was NCT03124524. Impact Statement What is already known on this subject: OCPs are the most appropriate treatment option for PD. There is no clear data about OCP containing dienogest for treatment in PD. Dienogest has been reported to be highly effective in the treatment of endometriosis and is also recommended as first-line therapy for pelvic pain-associated endometriosis. What the results of this study add: In this study, although there was no superiority in pain relief between the treatment groups, lower VAS scores and lower RI values of uterine arteries were seen after treatment. Both OCPs relieve pain in severe PD. There was no serious adverse effect in the patients. What the implications are of these findings for clinical practice and/or further research: Estradiol valerate/dienogest, which is a routinely prescribed drug for heavy menstrual bleeding in women who desire oral contraception, is as effective as ethinylestradiol/drospirenone in pain relief.

Efficacy of Guizhi Fuling Wan for primary dysmenorrhea: protocol for a randomized controlled trial

“…Meanwhile, absenteeism from school and work due to severe PD has been as high as 14%, seriously affecting their quality of life [ 4 , 5 ]. Currently, the most commonly used clinical pharmacological therapies are non-steroidal anti-inflammatory drugs (NSAIDs) and oral contraceptives [ 6 , 7 ]. Given that 10–20% of PD patients do not respond to the treatment of NSAIDs and that some patients cannot tolerate their side effects or are unsuitable for their indications [ 8 , 9 ], alternative therapies have become an important addition for PD treatment, in which Chinese herbal medicine (CHM) has played the essential role.…”

Comparison of two drospirenone-containing oral contraceptives for their effect on the ovary, menstrual cycle, acne, and side-effect profile: 20 µg ethinylestradiol/3 mg drospirenone (24/4) versus 30 µg ethinylestradiol/3 mg drospirenone (21/7)

“…The strength of our work was the comparison of tablets with a fixed progestin dose (3mg drospirenone) but different EE doses (20mcg-30mcg) and different hormone-free intervals. Studies in the literature have mostly compared the tablets for cycle control and bleeding patterns or only in one aspect [23][24][25]. The presented study is a comprehensive, multifaceted study of two formulations with two different estradiol doses, including the incidence of side-effects, premenstrual symptoms, dyspareunia and dysmenorrhea pain scores, and effects on acne, together with cycle control.…”

Efficacy of Guizhi Fuling Wan for Primary dysmenorrhea: protocol for a randomised controlled trial

“…Previous research indicates that prostaglandins (PGs) play a signi cant role in dysmenorrhea's pathomechanism, and there are complex biochemical reactions between the proin ammatory factors, endocrine, and vascular [7]. At present, the most frequently prescribed treatments are nonsteroidal anti-in ammatory drugs (NSAIDs) and oral contraceptives [8][9]. Despite their well-recognized e cacy, professional societies recommend using NSAIDs with caution, balancing the various potential gastrointestinal, cardiovascular, and renal adverse events [10].…”