Hormonal contraception in women with endometriosis: a systematic review

Grandi, Giovanni; Barra, Fabio; Ferrero, Simone; Sileo, Filomena Giulia; Bertucci, Emma; Napolitano, A; Facchinetti, Fabio

doi:10.1080/13625187.2018.1550576

Cited by 83 publications

(42 citation statements)

References 70 publications

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“…Although several medical treatments can be efficacy, high rate of symptoms recur after withdrawal should be noted. Thus, these medicines may be used for prolonged periods of time, even years [19][20][21][22][23]. When bowel endometriosis seriously impacts quality of life, surgical resection is the preferred treatment [19].…”

Section: Discussionmentioning

confidence: 99%

Safety and long-term impacts on quality of life of segmental bowel resection for bowel endometriosis: a single-centred 5-year follow-up

Liu¹,

Liang²,

Chen³

et al. 2019

Preprint

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Purpose: To evaluate the long-term efficacy of segmental bowel resection for bowel endometriosis and the impact of post-operative complications on clinical outcomes.Methods: 62 symptomatic patients with bowel endometriosis undergoing segmental bowel resection from Jun. 2010 to Jan. 2014 were recruited. A visual analogue scale (VAS) and SF-36 questionnaire were administered before and at least 5 years after surgery. Post-operative complications and pregnancy were also recorded. Median follow-up after operation was 76 months (62-105 months).Results: 62 patients underwent laparoscopic segmental bowel resection, one of which converted to laparotomy. All patients complained of obvious pain symptoms, including dysmenorrhea, dyspareunia, bowel movement pain, chronic pelvic pain and tenesmus. Dysmenorrhea was the most frequent. The relief of all pain symptoms after surgery was statistically significant (P<0.001). The scores for 8 domains of SF-36 questionnaire were significant improved after operation (P<0.001), and the post-operative scores were improved to the level of Chinese female population. Post-operative complication included 18 cases of urinary retention, 4 rectovaginal fistulas, 2 cases of vaginal dehiscence, and 1 case each of thrombogenesis, diffuse peritonitis, peripheral nerve injury, bacteraemia, incomplete intestinal obstruction and mucus bloody stool. All of these patients recovered well. There was no significant difference in post-operative SF-36 questionnaire scores between the patients with and without complications.Conclusion: Segmental bowel resection can significantly relieve pain and improve long-term quality of life for patients with bowel endometriosis. Despite the relatively high complication rate, the complications had little impact on the improvement of quality of life.

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Section: Discussionmentioning

confidence: 99%

Safety and long-term impacts on quality of life of segmental bowel resection for bowel endometriosis: a single-centred 5-year follow-up

Liu¹,

Liang²,

Chen³

et al. 2019

Preprint

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“…[22][23][24] COCs also improve menstrual cycle irregularities and symptoms of dysmenorrhea. [25][26][27] If COCs are considered in DOACtreated patients with VTE, a preference for second-generation COCs containing ≤35 μg ethinylestradiol combined with a lower-risk progestogen (levonorgestrel, norethisterone, or norgestimate) is recommended. 28,29 However, even these COCs should be stopped when anticoagulation is terminated.…”

Section: Covalent Modification Of the Fxaα Active Site Inhibits Cleavage Frommentioning

confidence: 99%

Reproductive issues in women on direct oral anticoagulants

Beyer‐Westendorf

Marten

2021

Research and Practice in Thrombosis and Haemostasis

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Direct oral anticoagulants (DOACs) are replacing warfarin and other vitamin K antagonists for a wide range of indications. Advantages of DOAC therapy are fewer food and drug interactions and fixed dosing without routine laboratory monitoring, making DOACs the perfect choice especially for younger patients, in whom the main indication for anticoagulation is prevention and treatment of venous thromboembolism (VTE). Although DOACs are safer and much more convenient than other anticoagulant alternatives, their profile may have drawbacks, especially for younger female patients in whom reproductive issues need special considerations. These may include the issue of heavy menstrual bleeding (HMB) during anticoagulant therapy, the embryotoxicity risk from inadvertent DOAC exposure during pregnancy, and the prevention or planning of pregnancies during DOAC therapy. This review summarizes the most relevant evidence in this increasingly important field of women’s health.

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“…Combined hormonal contraceptives, including COCs, are relatively inexpensive, with a well-established safety profile. Although there is some evidence that COCs can be effective in relieving dysmenorrhea, the off-label use of COCs in the treatment of endometriosis has been largely based on data from uncontrolled trials 16,66,67 . Therefore, there remains a lack of solid clinical trial evidence supporting the efficacy of COCs in alleviating the symptoms of endometriosis, such as pain 16,68 .…”

Section: Comparison Of Combined Oral Contraceptives and Dienogestmentioning

confidence: 99%

“…Unlike COCs, dienogest 2 mg has not been developed as a contraceptive, and barrier contraception is recommended during treatment to prevent pregnancy, although ovulation inhibition was demonstrated in early clinical trials 17,72 . Numerous studies have shown that progestin-releasing intrauterine systems or implants improve pelvic pain, dysmenorrhea, and quality of life in women with surgically confirmed endometriosis 66,73 .…”

Section: Comparison Of Combined Oral Contraceptives and Dienogestmentioning

confidence: 99%

Use of dienogest in endometriosis: a narrative literature review and expert commentary

Murji

Biberoğlu²,

Leng

et al. 2020

Current Medical Research and Opinion

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Objective: Endometriosis affects up to 10% of women of reproductive age, and the main goal of treatment is to relieve symptoms. Progestins have been the mainstay of endometriosis suppression, of which dienogest has become an important option in many parts of the world. This is an expert literature review, with recommendations on the use of dienogest in the context of various clinical considerations when treating endometriosis. Methods: A search of PubMed was conducted for papers published between 2007 and 2019 on the use of dienogest in endometriosis. Experts reviewed these and included those they considered most relevant in clinical practice, according to their own clinical experience. Results: Evidence regarding the long-term use (>15 months) of dienogest for the management of endometriosis is presented, with experts concluding that the efficacy of dienogest should be assessed primarily on its impact on pain and quality of life. Fertility preservation, the option to avoid or delay surgery, and managing bleeding irregularities that can occur with this treatment are also considered. Counseling women on potential bleeding risks before starting treatment may be helpful, and evidence suggests that few women discontinue treatment for this reason, with the benefits of treatment outweighing any impact of bleeding irregularities. Conclusions: Overall, the evidence demonstrates that dienogest offers an effective and tolerable alternative or adjunct to surgery and provides many advantages over combined hormonal contraceptives for the treatment of endometriosis. It is important that treatment guidelines are followed and care is tailored to the woman's individual needs and desires.

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Hormonal contraception in women with endometriosis: a systematic review

Cited by 83 publications

References 70 publications

Safety and long-term impacts on quality of life of segmental bowel resection for bowel endometriosis: a single-centred 5-year follow-up

Safety and long-term impacts on quality of life of segmental bowel resection for bowel endometriosis: a single-centred 5-year follow-up

Reproductive issues in women on direct oral anticoagulants

Use of dienogest in endometriosis: a narrative literature review and expert commentary

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