Fertil Steril. 2008 Nov;90(5):1583-8.
Low-dose oral contraceptive pill for dysmenorrhea associated with endometriosis:
a placebo-controlled, double-blind, randomized trial.
Harada T, Momoeda M, Taketani Y, Hoshiai H, Terakawa N.
Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan. tasuku@grape.med.tottori-u.ac.jp
Objective:
To evaluate the efficacy of a low-dose oral contraceptive pill (OCP) for patients with dysmenorrhea associated with endometriosis.
Design:
A double-blind, randomized, placebo-controlled trial. SETTINGS: Clinical trial sites in Japan.
Patients:
One hundred patients with dysmenorrhea associated with endometriosis. Most enrolled patients had radiologic evidence of endometriosis rather than surgical diagnosis.
Interventions:
Patients were randomly assigned to receive either monophasic OCP (ethinylestradiol plus norethisterone) or placebo. Participants used their usual pain medications as needed during the trial.
Main Outcome Measures:
After four cyclic treatments, we used a zero- to three-point verbal rating scale and a visual analogue scale to measure the severity of disability because of dysmenorrhea in daily life, and the patients' use of analgesics.
Results:
Total dysmenorrhea scores assessed by the verbal rating scale were significantly decreased at the end of treatment in both groups. From the first cycle through the end of treatment, dysmenorrhea in the OCP group was significantly milder than in the placebo group. Nonmenstrual pelvic pain was present at baseline in 24.5% (12 of 49) of the OCP group and 34.0% (16 of 47) of the placebo group. The volume of endometrioma (larger than 3 cm in diameter) was significantly decreased in the OCP group, but not in the placebo group. No serious adverse events related to using OCPs occurred.
Conclusions:
The present study clearly demonstrated for the first time that OCPs could be used to effectively and safely treat pain associated with endometriosis.
Please click on the required question.
- Pelvic Pain. Is this a common problem?
- What are the common causes of pelvic pain in women?
- What are the more common gynaecological causes of pelvic pain?
- What are the more common non-gynaecological causes of pelvic pain?
- What are primary and secondary dysmenorrhoea - painful periods?
- What is retrograde menstruation?
- How can dysmenorrhoea - painful periods be treated?
- What are ovarian cysts?
- How do ovarian cysts cause pain?
- How are ovarian cysts diagnosed?
- How are ovarian cysts treated?
- I think I may be pregnant and I have some pelvic pain. What should I do?
- What is pelvic inflammatory disease and how can it be treated?
- Mittelschmertz
- What are fibroids?
- I have fibroids. What difficulties might they cause for me?
- How are fibroids diagnosed?
- How could my fibroids be treated?
ENDOMETRIOSIS
- What is endometriosis?
- How prevalent is endometriosis?
- What causes endometriosis?
- How can my endometriosis be treated?
- How can my doctor determine the cause of my pelvic pain?
- What investigations might be recommended by my gynaecologist to investigate my pelvic pain?
- What is laparoscopy?
- What are pelvic adhesions?
- I have chronic pelvic pain. Could this be related to adhesions?
- What is uterine retroversion (retroverted uterus)
- Does a retroverted uterus (backward tilted uterus) cause symptoms?
- How is a retroverted uterus - backward tilted uterus - treated?
- What is pelvic congestion?
- What causes pain associated with sexual intercourse (dyspareunia)
- How can painful sexual intercourse (dyspareunia) be treated?
- What is a pelvic mass?
IRRITABLE BOWEL SYNDROME - IBS
- What is irritable bowel syndrome?
- How can we find out if I have irritable bowel syndrome?
- Is irritable bowel syndrome (IBS) a common condition?
- What causes IBS?
- What is the pain associated with IBS like?
- Can IBS be mistaken for gynaecological problems?
- How can my IBS be treated?
- What other treatments are available for IBS?
- What can be done to reduce the amount of bowel gas(flatus)
- What is constipation?
- What causes constipation?
- How can constipation be treated?
- How could we summarise the treatments that are available for my pelvic pain?
- Where can I obtain more information?
- Pelvic Pain Support Groups.
- Endometriosis Support Groups.
- IBS Support Groups.
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
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