Progestagens and anti-progestagens for pain associated with endometriosis.

摘要: Background Endometriosis is a chronic inflammatory condition defined by the presence of glands and stroma outside uterine cavity. It occurs in 7% to 10% all women reproductive age may present as pain or infertility. The pelvic be form dysmenorrhoea, dyspareunia pain. Initially combination estrogens progestagens was used create pseudopregnancy alleviate symptoms associated with endometriosis. Progestagens alone anti-progestagens have been considered alternatives because they are inexpensive better side effect profile than other choices. Objectives To determine effectiveness both treatment painful ascribed diagnosis endometriosis. Search methods We search strategy Menstrual Disorders Subfertility Group identify publications which described might randomised controlled trials (RCTs) any progestagen anti-progestagen symptomatic We updated review 2011. Selection criteria We only RCTs compared use interventions, placebo no for alleviation endometriosis. Data collection analysis We added six new studies, bringing total included studies 13 update this review. newly evaluated (comparisons placebo, danazol, oral subdermal contraceptive, contraceptive pill gonadotrophin-releasing hormone (GnRH) analogue drugs). remaining gestrinone GnRH analogues itself. Main results The medroxyprogesterone acetate (100 mg daily) appeared more effective at reducing up 12 months follow-up (MD -0.70, 95% CI -8.61 -5.39; P < 0.00001) placebo. There evidence significantly cases acne (six versus one) oedema (11 group difference objective efficacy between dydrogesterone placebo. There benefit depot administration treatments (low dose leuprolide acetate) reduced symptoms. experienced adverse effects. There overall over medical self-reported efficacy. Amenorrhoea bleeding were frequently reported groups. There (gestrinone) danazol. (leuprorelin) found improve dysmenorrhoea 0.82, 0.15 1.49; = 0.02) although it also increased hot flushes (OR 0.20, 0.06 -0.63; 0.006). Authors' conclusions There limited support