Estroprogestin vs. gonadotrophin agonists plus estroprogestin in the treatment of endometriosis-related pelvic pain: a randomized trial. Gruppo Italiano per lo Studio dell'Endometriosi.

Abstract

OBJECTIVE:

This is a randomized clinical trial comparing estroprogestin (E/P) pill given for 12 months vs. gonadotrophin releasing hormone agonist (GNRHa) given for 4 months followed by E/P pill treatment for 8 months in the relief of endometriosis-related pelvic pain.

METHODS:

Eligible for the study were women with laparoscopically confirmed endometriosis and pelvic pain lasting 3-12 months after diagnosis. Eligible women were randomly assigned to treatment with E/P pill (gestroden 0.75 mg and ethynlestradiol 0.03 mg) for 12 months (47 patients) vs. tryptorelin 3.75 mg slow release every 28 days for 4 months followed by E/P pill for 8 months (55 patients).

RESULTS:

At baseline, dysmenorrhea was reported in 46 women allocated to E/P pill only (97.9%), and in all the 55 women allocated to GNRHa+E/P pill. The corresponding value at the 12 months follow-up visit was 14 subjects (35.9%) and 16 subjects (34.8%). The baseline median values of the multidimensional and analog scale were for dysmenorrhea 4 and 6 in the EP only and 3 and 6 in the GNRHa+E/P group. The corresponding value at the 12 months follow-up visit were 2 and 6 and 0 and 5. Non-menstrual pain was reported, respectively, at baseline and 12 month visit by 46 (97.9%) and 15 (38.5%) subjects in the E/P pill group and 49 (89.1%) and 17 (37.0%) of the GNRHa+E/P pill one. The baseline median values of the multidimensional and analog scale were for non-menstrual pain 3 and 5 in the E/P only and 2 and 6 in the GNRHa+E/P group. The corresponding values at the 12 month follow-up visit were 0 and 4 and 0 and 4. These differences between the two groups were not statistically significant.

CONCLUSIONS:

1 year after randomization, the two treatment schedules show similar relief of pelvic pain in women with endometriosis.

• Authors: F Parazzini, E Di Cintio, L Chatenoud, S Moroni, I Ardovino, E Struzziero, L Falsetti, A Bianchi, G Bracco, A Pellegrini, C Bertulessi, C Romanini, E Zupi, M Massobrio, D Guidetti, L Troiano, P Beretta, M Franchi
• Journal: European journal of obstetrics, gynecology, and reproductive biology (Eur J Obstet Gynecol Reprod Biol) Vol. 88 Issue 1 Pg. 11-4 (Jan 2000) ISSN: 0301-2115 [Print] Ireland
• PMID: 10659911 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Luteolytic Agents
• Triptorelin Pamoate
• Gonadotropin-Releasing Hormone
• Progesterone
• Estradiol

Topics

• Adult
• Dysmenorrhea (drug therapy, etiology)
• Endometriosis (complications, drug therapy)
• Estradiol (administration & dosage, agonists)
• Female
• Follow-Up Studies
• Gonadotropin-Releasing Hormone (agonists)
• Humans
• Luteolytic Agents (administration & dosage)
• Pain (drug therapy, etiology)
• Pain Measurement
• Progesterone (administration & dosage, agonists)
• Triptorelin Pamoate (administration & dosage)