Depot medroxyprogesterone acetate versus an oral contraceptive combined with very-low-dose danazol for long-term treatment of pelvic pain associated with endometriosis.

Abstract

OBJECTIVE:

Our purpose was to evaluate the efficacy and safety of depot medroxyprogesterone acetate versus an oral contraceptive combined with very-low-dose danazol in the long-term treatment of pelvic pain in women with endometriosis.

STUDY DESIGN:

Eighty patients with endometriosis and moderate or severe pelvic pain were randomized to treatment for 1 year with intramuscular depot medroxyprogesterone acetate 150 mg every 3 months or a cyclic monophasic oral contraceptive (ethinyl estradiol 0.02 mg, desogestrel 0.15 mg) combined with oral danazol 50 mg a day for 21 days of each 28-day cycle. The women were asked to grade the degree of their satisfaction at the end of therapy. Variations in severity of symptoms during treatment were determined by a 10 cm visual analog and a 0- to 3-point verbal rating scale.

RESULTS:

Twenty nine of 40 subjects (72.5%) in the depot medroxyprogesterone acetate group were satisfied after 1 year of therapy compared with 23 of 40 (57.5%) in the oral contraceptive plus danazol group (chi 2(1) = 1.37, p = 0.24, odds ratio 1.95, 95% confidence interval 0.76 to 4.97). A significant decrease was observed in all symptom scores in both study groups. At 1-year assessment dysmenorrhea was significantly greater in women allocated to oral contraceptive plus danazol.

CONCLUSION:

Depot medroxyprogesterone acetate seems to be an effective, safe, and convenient low-cost treatment for pelvic pain associated with endometriosis. However, women should be carefully counseled regarding menstrual changes and the potential prolonged delay in the return of ovulation.

• Authors: P Vercellini, O De Giorgi, S Oldani, I Cortesi, S Panazza, P G Crosignani
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 175 Issue 2 Pg. 396-401 (Aug 1996) ISSN: 0002-9378 [Print] United States
• PMID: 8765259 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Contraceptives, Oral
• Delayed-Action Preparations
• Medroxyprogesterone Acetate
• Danazol

Topics

• Adolescent
• Adult
• Contraceptives, Oral (therapeutic use)
• Danazol (administration & dosage, therapeutic use)
• Delayed-Action Preparations
• Drug Therapy, Combination
• Endometriosis (physiopathology)
• Female
• Humans
• Medroxyprogesterone Acetate (administration & dosage, adverse effects, therapeutic use)
• Palliative Care
• Pelvic Pain (drug therapy)
• Time Factors