Desogestrel‐only contraceptive pill versus sequential contraceptive vaginal ring in the treatment of rectovaginal endometriosis infiltrating the rectum: a prospective open‐label comparative study

Abstract

Both hormonal therapies are efficacious in treating symptoms caused by rectovaginal endometriosis infiltrating the rectum. Patient satisfaction is higher with the desogestrel-only pill than with a vaginal ring.

Reevaluating response and failure of medical treatment of endometriosis: a systematic review

“…The median VAS score for dysmenorrhea decreased to 0.5 cm (range 0.0–3.1 cm, four treatment arms) after treatment for 12 months 30, 43. At the end of 12 months’ treatment, median VAS scores for dyspareunia and dyschezia had reduced by a lesser extent than the other pain symptoms, with values of 1.4 cm (range 1.2–3.2 cm, five treatment arms) (30) and 3.0 cm (range 1.9–4.1 cm, two treatment arms) (43), respectively.…”

“…During treatment, median VAS scores for pain or pelvic pain decreased to 1.5 cm (range 1.2–5.2 cm, seven treatment arms) after 3–6 months 30, 34, 39, 41, 42 and decreased further to 0.8 cm (range 0.2–3.5 cm, five treatment arms) after 12 months 30, 43. The median VAS score for dysmenorrhea decreased to 0.5 cm (range 0.0–3.1 cm, four treatment arms) after treatment for 12 months 30, 43.…”

“…of articlesPublication year(s)Total no. of patientsaTreatment duration, moStudy typeFunding sourcebDanazol31982–19984814 to ≥6Prospective cohort study (n = 2) 9, 10; retrospective study (n = 1) (11)Nonindustry (n = 3)Gestrinone319957026RCT (n = 3) 12, 13, 14Nonindustry (n = 3)Mifepristone120162706RCT (n = 1) (15)Nonindustry (n = 1)GnRH agonists141988–20002,7833–6RCT (n = 12) 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27; prospective cohort study (n = 2) 28, 29Industry (n = 8); partial industry (n = 3); nonindustry (n = 3)GnRH agonists plus add-back therapy41998–20167385–12RCT (n = 3) 30, 31, 32; prospective cohort study (n = 1) (33)Industry (n = 1); partial industry (n = 1); nonindustry (n = 2)Progestins142000–20162,6943–12RCT (n = 8) 34, 35, 36, 37, 38, 39, 40, 41; prospective cohort study (n = 5) 42, 43, 44, 45, 46; retrospective study (n = 1) (47)Industry (n = 7); partial industry (n = 2); nonindustry (n = 5)CHCs…”

“…Patient-reported VAS data were available from six studies 30, 34, 39, 42, 43, 48; an additional four articles 40, 44, 45, 46 presented VAS data in graphic form only and were not included in the analysis. Owing to the paucity of data, values were pooled for all medical therapies; patients treated with medical therapy after surgery were not included.…”

“…Data for individual medical therapies are presented in Supplemental Table 6. Median VAS scores at baseline for pain or pelvic pain, dysmenorrhea, dyspareunia, and dyschezia were 6.0 cm (range 5.6–8.0 cm, nine treatment arms) 30, 34, 39, 42, 43, 6.1 cm (range 5.8–6.7 cm, six treatment arms) 30, 43, 48, 5.8 cm (5.4–5.9 cm, five treatment arms) 30, 43, and 5.2 cm (5.1–5.3 cm, two treatment arms) (43), respectively (Fig. 3).…”