{"paper_id":"66acf649-8fa0-4524-9cbb-c874dad7e0db","body_text":"Abstract\nProgestins, which are synthetic progestational compounds, have been used in the\nmanagement of symptomatic endometriosis, both as primary therapy and as an adjunct to\nsurgery. Several oral compounds have been used for this purpose, and different degrees of\nbenefits have been shown. The lack of a standardized instrument to evaluate painful\nsymptoms makes comparative analysis very difficult. We performed a systematic search of\nthe Pubmed database from January 1980 to January 2015. The database used the term\n“endometriosis” as the relevant medical subject heading; selected sub- headings were “progestins”, “medical\ntherapy”, “review” and “randomized controlled trials”, “controlled trials”, “case-control studies”, and\n“descriptive studies”. We aimed to review all available trials in order to investigate the medical treatment of\nendometriosis solely with progestins, with special attention to pharmacodynamic activity. The drugs studied\nwere cyproterone acetate, norethisterone acetate, medroxyprogesterone acetate, levonorgestrel, etonogestrel,\ndienogest, and selective progesterone receptor modulators. However, it is very difficult to reach a definitive\nconclusion because most trials were small, retrospective, and uncontrolled. Nevertheless, it is clear that\nprogestins are generally safe, effective, and well tolerated and should be considered as the first line of medical\ntreatment in symptomatic endometriosis provided the patients have no desire for pregnancy.\nKeywords: Cyproterone acetate, dienogest, dysmenorrhea, endometriosis, etonogestrel, levonorgestrel, medroxyprogesterone acetate, norethisterone acetate, pelvic pain, progestins.\n71\n1\n1","source_license":"CC0","license_restricted":false}