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

Vercellini P, Paolo Vercellini, P Vercellini, O De Giorgi, Olga De Giorgi, De Giorgi O, S Oldani, Sabina Oldani, Oldani S, I Cortesi, Ilenia Cortesi, Cortesi I, Panazza S, Stefania Panazza, S Panazza, P G Crosignani, Crosignani PG, Pier Giorgio Crosignani
American Journal of Obstetrics and Gynecology · 1996 · vol. 175(2) , pp. 396–401 · doi:10.1016/s0002-9378(96)70152-7 · PMID:8765259 · W2099208499
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This study compared depot medroxyprogesterone acetate to an oral contraceptive plus low-dose danazol for long-term treatment of endometriosis-related pelvic pain.

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Abstract

ObjectiveOur 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 designEighty 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.ResultsTwenty 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.ConclusionDepot 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.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Contraceptives, Oral Danazol Endometriosis Medroxyprogesterone Acetate Pelvic Pain Adolescent Adult Contraceptives, Oral Danazol Danazol Delayed-Action Preparations Drug Therapy, Combination Endometriosis Female Humans Medroxyprogesterone Acetate Medroxyprogesterone Acetate Medroxyprogesterone Acetate Palliative Care Pelvic Pain

Citation neighborhood

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References (29)

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