Continuous versus cyclic oral contraceptives after laparoscopic excision of ovarian endometriomas: a systematic review and metaanalysis

Muzii, Ludovico; Tucci, Chiara Di; Achilli, Chiara; Donato, Violante Di; Musella, Angela; Palaia, Innocenza; Panici, Pierluigi Benedetti

doi:10.1016/j.ajog.2015.08.074

Cited by 89 publications

(45 citation statements)

References 18 publications

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“…One further RCT187 also reported a reduction in endometriosis-associated pelvic pain, an improvement in sexual activity and quality of life in women on a EE/dienogest continuous regimen compared to a 21/7 regimen. Another systematic review188 reported that a significantly lower postoperative dysmenorrhoea recurrence rate was observed in continuous compared to cyclical COC users; however, this study did not identify significant differences in dyspareunia, non-menstrual pelvic pain, or endometriosis recurrence rates between continuous and cyclical users.…”

Section: Non-contraceptive Health Benefits Associated With Chc Usecontrasting

confidence: 72%

FSRH Guideline (January 2019, amended October 2023) Combined Hormonal Contraception

2019

BMJ Sex Reprod Health

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Section: Non-contraceptive Health Benefits Associated With Chc Usecontrasting

confidence: 72%

FSRH Guideline (January 2019, amended October 2023) Combined Hormonal Contraception

2019

BMJ Sex Reprod Health

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“…Based on a more recent randomized control trial (RCT) in 100 patients, low dose OCPs decrease pain more significantly than placebo on the Visual Analog Scale (VAS) (Harada et al 2008). Continuous OCPs decrease recurrence rates of dysmenorrhea after surgical therapy when compared to cyclic OCPs (Muzii et al 2015, Zorbas et al 2015). Of the progestins, the 19-nortestosterone derivatives are less androgenic and offer better side effect profiles (Angioni et al 2014).…”

Section: Treatmentsmentioning

confidence: 99%

Endometriosis: where are we and where are we going?

Greene¹,

Lang²,

Kendziorski³

et al. 2016

Reproduction

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Endometriosis currently affects ∼5.5 million reproductive-aged women in the U.S. with symptoms such as painful periods (dysmenorrhea), chronic pelvic pain, pain with intercourse (dyspareunia), and infertility. It is defined as the presence of endometrial tissue outside the uterine cavity and is found predominately attached to sites within the peritoneal cavity. Diagnosis for endometriosis is solely made through surgery as no consistent biomarkers for disease diagnosis exist. There is no cure for endometriosis and treatments only target symptoms and not the underlying mechanism(s) of disease. The nature of individual predisposing factors or inherent defects in the endometrium, immune system, and/or peritoneal cavity of women with endometriosis remains unclear. The literature over the last 5 years (2010-2015) has advanced our critical knowledge related to hormones, hormone receptors, immune dysregulation, hormonal treatments, and the transformation of endometriosis to ovarian cancer. In this review, we cover the aforementioned topics with the goal of providing the reader an overview and related references for further study to highlight the progress made in endometriosis research, while concluding with critical areas of endometriosis research that are urgently needed.

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“…[46][47][48] However, a recent meta-analysis suggested that a continuous regimen may be preferable, due to significantly better results in terms of dysmenorrhea recurrence rates, and a strong trend to better results in cyst recurrence rates. 49 The relative risk (RR) for dysmenorrhea recurrence after a continuous versus cyclic OC regimen was reported as 0.24 (95% confidence interval [CI]: 0.06-0.91), whereas the RR for cyst recurrence was reported as 0.54 (95% CI: 0.28-1.05). Nonsignificant differences between the two schedules were reported for chronic pelvic pain and dyspareunia.…”

Section: Combined Medical/surgical Managementmentioning

confidence: 99%

Management of Endometriomas

et al. 2016

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Ovarian endometriomas affect 17 to 44% of women with endometriosis, and are often associated with pelvic pain and infertility. Treatment options include expectant management, medical and/or surgical treatment, and in vitro fertilization and embryo transfer (IVF-ET). The choice of treatment depends mostly on the associated symptoms. In most cases, surgery is the preferred choice, since endometriomas do not respond to medical treatment, which may only treat associated pain. In case of infertility, IVF-ET may be a suitable alternative to surgery, particularly when there is no associated pain. According to the best available scientific evidence, laparoscopic excision of the endometrioma wall should be considered the procedure of choice. Concerns have been raised as to the possibility that surgical excision may damage the ovarian reserve, but recent evidences demonstrate that part of the damage may be due to the presence of the endometrioma itself. Indication to surgical treatment should balance the possible risks of damaging the ovarian reserve with the advantages of surgery in terms of satisfactory pain relief rates and pregnancy rates, and of obtaining tissue specimen for ruling out the rare cases of unexpected ovarian malignancy. A score system to guide the clinician in the decision to perform or withhold surgery is presented.

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Continuous versus cyclic oral contraceptives after laparoscopic excision of ovarian endometriomas: a systematic review and metaanalysis

Cited by 89 publications

References 18 publications

FSRH Guideline (January 2019, amended October 2023) Combined Hormonal Contraception

FSRH Guideline (January 2019, amended October 2023) Combined Hormonal Contraception

Endometriosis: where are we and where are we going?

Management of Endometriomas

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