Comparison of contraceptive ring and patch for the treatment of symptomatic endometriosis

Vercellini, Paolo; Barbara, Giussy; Somigliana, Edgardo; Bianchi, Stefano; Abbiati, Annalisa; Fedele, Luigi

doi:10.1016/j.fertnstert.2009.01.071

Cited by 97 publications

(78 citation statements)

References 38 publications

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“…The vaginal ring releasing 15 mg EE and 120 mg etonogestrel was compared with the patch containing 20 mg EE and 150 mg norelgestromin/daily both were associated with poor bleeding control when used continuously. Regarding pain symptoms the ring was more effective than the patch in patients with rectovaginal endometriosis [8]. The postoperative use of estrogen/progestogen combinations can be effective in prevention of anatomical relapse or symptom recurrence after conservative surgery for endometriosis.…”

Section: Estrogen/progestogen Combinations and Peritoneal Endometriosismentioning

confidence: 92%

Hormonal contraceptives and endometriosis/adenomyosis

Schindler¹

2010

Gynecological Endocrinology

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Over the past 50 years hormonal contraceptives have gradually developed to be cost-effective medical treatment modalities for primary and secondary therapy of endometriosis/adenomyosis. This is particularly true for the various estrogen/ progestogen combinations as monophasic -particularly progestogen-dominant -preparations in cyclic, long-cyclic and continuous treatment forms. An alternative is the progestogen-only therapy used continuously. Therapeutic effects have been shown for peritoneal, ovarian and deep-infiltrating endometriosis as well as for adenomyosis. An individualized, medical long-term treatment concept to control endometriosis/adenomyosis-related symptoms, endometriosis/adenomyosis development and minimizing the recurrence rate needs to be further studied in women, who do not desire to become pregnant.

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Section: Estrogen/progestogen Combinations and Peritoneal Endometriosismentioning

confidence: 92%

Hormonal contraceptives and endometriosis/adenomyosis

Schindler¹

2010

Gynecological Endocrinology

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“…The above scales and questionnaires have been described previously in detail [7, 13-16]. The presence and severity of dysmenorrhea, deep dyspareunia, non-menstrual pelvic pain, and dyschezia were assessed using an 11-point NRS, with 0 indicating absence of pain and 10 presence of pain as bad as it could be.…”

Section: Methodsmentioning

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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“…The same types of hormone combinations used in OCPs can be delivered by monthly vaginal rings and weekly transdermal patches without the discomfort of daily administration. These alternative routes of administration provide constant plasma drug levels and avoid first-pass hepatic metabolism (172).…”

Section: Contraceptive Methodsmentioning

confidence: 99%

“…In a cohort study, 207 patients with recurrent endometriosis-related pelvic pain after surgical treatment received a continuous estrogen-progestogen combination from either a vaginal ring or a transdermal system for 12 months (172). Women using the ring (n ¼ 123) were statistically significantly more satisfied and showed better compliance with treatment than those who chose the patch (n ¼ 84).…”

Section: Contraceptive Methodsmentioning

confidence: 99%