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Progestagens and anti-progestagens for pain associated with endometriosisPrentice A, Deary A, Bland ES
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SummaryProgestagens and anti-progestagens for pain associated with endometriosisProgestagens and anti-progestagens can help reduce the pain from endometriosis. Endometriosis is a painful condition where tissue from the lining of the womb (uterus) is outside the uterus as well. It can cause pain in the abdomen generally, and during periods (menstruation) or sex. Endometriosis can also lead to infertility. Treatments include surgery, or drugs to try and shrink the tissue. Progestagens and anti-progestagens are some of the hormonal drugs used. The review of trials found some evidence that these drugs can help reduce the pain from endometriosis.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
April 24. 2000 AbstractBackgroundEndometriosis is a gynaecological condition that presents either with the problem of infertility or with painful symptoms. The clinical observation of an apparent resolution of symptoms during pregnancy gave rise to the concept of treating patients with a pseudo-pregnancy regime. Initially combinations of high dose oestrogens and progestagens were used but this was subsequently replaced by progestogens alone. More recently progestogens of both progestagens and anti-progestagens in the treatment of symptomatiprogestogenssis ObjectivesTo determine the effectiveness of both the progestagens and anti-progestagens in the treatment of painful symptoms ascribed to the diagnosis of endometriosis. Search strategyThe search strategy of the Menstrual Disorders and Subfertility Group was utilised to identify all publications which described or might have described randomised trials of any progestagen or any anti-progestagen in the treatment of symptomatic endometriosis. Selection criteriaTrials were included if they were randomised and considered the effectiveness of either a progestagen or an anti-progestagen in the treatment of painful symptoms associated with endometriosis. Data collection and analysisSeven studies were considered to be appropriate for inclusion in this review. Only three studies evaluating progestagens were included (comparison with placebo, danazol and oral contraceptive plus danazol). All other studies compared the anti-progestagen, gestrinone, with other medical therapies. Main resultsProgestagens appear to be an effective therapy for the painful symptoms associated with endometriosis. Gestrinone is as effective as other established medical therapies (danazol and GnRH analogues). Authors' conclusionsThe limited available data suggests that both continuous progestagens and anti-progestagens are effective therapies in the treatment of painful symptoms associated with endometriosis. Progestagens given in the luteal phase are not effective. These conclusions should be accepted cautiously due to a lack of data. |