Pelvic pain and quality of life of women with endometriosis during quadriphasic estradiol valerate/dienogest oral contraceptive: a patient-preference prospective 24-week pilot study.

Abstract

OBJECTIVE:

The progestin dienogest (DNG) given alone effectively reduces pelvic pain of women with endometriosis. It is not clear whether the same occurs when DNG is associated with estradiol (E2).

DESIGN:

Patient preference prospective observational study.

SETTING:

Outpatient centre of university hospital.

PATIENTS:

40 patients with endometriosis and menstrual pain.

INTERVENTIONS:

24-week treatment with a quadriphasic association of E2 valerate (E2V) and DNG or a nonsteroidal anti-inflammatory drug (NSAID) to be used only in case of pain (ketoprofene 200-mg tablets).

MAIN OUTCOME MEASURES:

Menstrual pain and, when present, intermenstrual pain, and dyspareunia were investigated by means of a 10-cm visual analogue scale (VAS). Quality of life was investigated by the short form 36 (SF-36) of the health-related quality of life questionnaire.

RESULTS:

Final study group consists of 34 patients, 19 in the E2V/DNG group and 15 in the NSAID group. After 24 weeks, no significant modification of menstrual pain, intermenstrual pain, dyspareunia, or SF-36 score was observed in the NSAID group. Treatment with E2V/DNG reduced the VAS score of menstrual pain by 61% (P < .0001). In the subgroups of women with intermenstrual pain or dyspareunia, E2V/DNG reduced these complaints by 65% (P = .013) and 52% (P = .016), respectively. The reduction in menstrual (P = .0001) and intermenstrual pain (p = 0.03) was significantly greater during E2V/DNG than NSAID. Quality of life improved during E2V/DNG (P = .0002), both in physical (P = .0003) and mental domains (P = .0065). Only a few minor adverse effects were described during E2V/DNG, and none caused withdrawal from treatment.

CONCLUSION:

In patients with endometriosis and pelvic pain, the 24-week administration of the quadriphasic association of E2V/DNG decreases pelvic pain and improves quality of life.

• Authors: Giovanni Grandi, Anjeza Xholli, Antonella Napolitano, Federica Palma, Angelo Cagnacci
• Journal: Reproductive sciences (Thousand Oaks, Calif.) (Reprod Sci) Vol. 22 Issue 5 Pg. 626-32 (May 2015) ISSN: 1933-7205 [Electronic] United States
• PMID: 25394646 (Publication Type: Journal Article, Observational Study)
• Copyright: © The Author(s) 2014.

Chemical References

• Contraceptives, Oral, Hormonal
• Drug Combinations
• estradiol valerate-dienogest
• Estradiol
• Nandrolone

Topics

• Adult
• Contraceptives, Oral, Hormonal (administration & dosage, adverse effects)
• Drug Combinations
• Dysmenorrhea (diagnosis, drug therapy, psychology)
• Endometriosis (diagnosis, drug therapy, psychology)
• Estradiol (administration & dosage, adverse effects, analogs & derivatives)
• Female
• Hospitals, University
• Humans
• Italy
• Nandrolone (administration & dosage, adverse effects, analogs & derivatives)
• Pain Measurement
• Patient Preference
• Pelvic Pain (diagnosis, drug therapy, psychology)
• Pilot Projects
• Prospective Studies
• Quality of Life
• Surveys and Questionnaires
• Time Factors
• Treatment Outcome