Ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen for the management of endometriosis-associated pelvic pain: a randomized controlled trial

Harada, Tasuku; Kosaka, Saori; Elliesen, Jörg; Yasuda, Masanobu; Itô, Makoto; Momoeda, Mikio

doi:10.1016/j.fertnstert.2017.07.1165

Cited by 73 publications

(87 citation statements)

References 39 publications

(42 reference statements)

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“…In a large, multicentre, placebo-controlled RCT conducted in women with symptomatic endometriosis, a low-dose OC substantially improved not only dysmenorrhoea, but also other pain symptoms, including non-menstrual pain and deep dyspareunia [17]. The findings of this Japanese study confirm the vast amount of published data concerning the appreciable degree of satisfaction with treatment that can be achieved with OCs in patients with the disease [3; Table 1].…”

Section: Pros and Cons Of Combined Oral Contraceptivessupporting

confidence: 69%

Medical treatment of endometriosis-related pain

Vercellini

Buggio

Frattaruolo

et al. 2018

Best Practice & Research Clinical Obstetrics & Gynaecol

128

101

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Available medical treatments for symptomatic endometriosis act by inhibiting ovulation, reducing serum oestradiol levels, and suppressing uterine blood flows. For this, several drugs can be used with a similar magnitude of effect, in terms of pain relief, independently of the mechanism of action. Conversely, safety, tolerability, and cost differ. Medications for endometriosis can be categorized into low-cost drugs including oral contraceptives (OCs) and most progestogens, and high-cost drugs including dienogest and GnRH agonists. As the individual response to different drugs is variable, a stepwise approach is suggested, starting with OCs or low-cost progestogens, and stepping up to high-cost drugs only in case of inefficacy or intolerance. OCs may be used in women with dysmenorrhea as their main complaint, and when only superficial peritoneal implants or ovarian endometriomas <5 cm are present, while progestogens should be preferred in women with severe deep dyspareunia and when infiltrating lesions are identified.

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Section: Pros and Cons Of Combined Oral Contraceptivessupporting

confidence: 69%

Medical treatment of endometriosis-related pain

Vercellini

Buggio

Frattaruolo

et al. 2018

Best Practice & Research Clinical Obstetrics & Gynaecol

128

101

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“…Upon closer examination, 13 articles (12 studies) did not meet the inclusion criteria due to use of hormonal treatment as an adjunct to surgery. Five studies (six publications) met our inclusion criteria Guzick 2011;Harada 2008;Harada 2017;Vercellini 1993). Vercellini 1993 was identified in the original search conducted in 1996, and was included in the previous version of this review (Davis 2007).…”

Section: Results Of the Searchmentioning

confidence: 99%

“…The search identified five parallel-design RCTs conducted in Egypt (Ali 2013), US (Guzick 2011), Japan (Harada 2008;Harada 2017), and Italy (Vercellini 1993). There was one single-centre trial (Vercellini 1993) and three multi-centre trials (Guzick 2011; Harada 2008; Harada 2017) conducted in hospitals.…”

Section: Study Design and Settingmentioning

confidence: 99%

Oral contraceptives for pain associated with endometriosis

Brown

Crawford

Datta

et al. 2018

Cochrane Database of Systematic Reviews

101

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“…In the Harada et al study (1) the scores of most severe pain were similar in all groups at baseline. Not surprisingly pain scores dropped more in the group treated with an oral contraceptive than the group treated with placebo.…”

mentioning

confidence: 75%