Randomized Study on the Effectiveness of Nomegestrol Acetate Plus 17β-Estradiol Oral Contraceptive vs Dienogest Oral Pill in Women with Endometriosis‑Associated Chronic Pelvic Pain

Salvatore Caruso, Antonio Cianci, Marco Iraci Sareri, Marco Marzio Panella, Giuseppe Caruso, Stefano Cianci
In: Research Square · 2022 · doi:10.21203/rs.3.rs-1323526/v1 · W4214679238
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that both nomegestrol acetate plus 17β-estradiol and dienogest reduced endometriosis-associated chronic pelvic pain, but dienogest showed greater improvement in quality of life and sexual function scores.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This randomized study compared a combined oral contraceptive containing 1.5 mg 17β-estradiol plus 2.5 mg nomegestrol acetate versus daily 2 mg dienogest in women with endometriosis-associated chronic pelvic pain, evaluating pain using the visual analog scale (VAS), quality of life with SF-36, and sexual function with FSFI plus sexual distress with FSDS across 3, 6, and 12 months. Both treatment groups showed significant within-group VAS improvement from baseline to 12 months, while between-group differences were limited, with a statistically significant advantage for dienogest at the 6-month point and a more favorable sexual function/quality-of-life profile for dienogest at 6 and 12 months. The paper notes attrition and reliance on intention-to-treat analyses with last observation carried forward for missing data, alongside reporting that outcomes were based on participants who were randomized after exclusions. This paper is centrally about endometriosis — it directly tests hormonal regimens (dienogest vs E2/NOMAC) for endometriosis-associated chronic pelvic pain and related quality-of-life and sexual function outcomes.

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Abstract

Abstract Background: To evaluate the effects of a combined oral contraceptive containing 1.5mg 17b-estradiol (E2) and 2.5mg nomegestrol acetate (NOMAC) or 2 mg/daily dienogest (DNG) oral progestin on endometriosis-associated chronic pelvic pain (CPP) and on the quality of life (QoL) and sexual function, by a randomized study design. Methods: The E2/NOMAC group and DNG group included 99 and 98 women, respectively. The levels of CPP were measured by the visual analogic scale (VAS). The QoL scores were investigated by the Short Form-36 (SF-36). Finally, the sexual function was studied using the Female Sexual Function Index (FSFI), while the sexual distress by the Female Sexual Distress Scale (FSDS). The study had 3, 6 and 12-month follow-ups. Results: The intra-group analysis showed an improvement of the VAS score from baseline to the 12-month follow-up in women of both groups (p<0.001). The inter-group comparison showed a similar improvement of CPP (p=0.06). Women on DNG had better SF-36 somatic (p<0.01) and FSFI scores (p<0.006) than women on E2/NOMAC at 6- and 12-month follow-ups. Conclusions: The results support the efficacy of both hormonal treatments, even if DNG was more effective than E2/NOMAC in a limited intergroup comparison. The research protocol was approved by the institutional review board of the Ethics Committee of the University Hospital Polyclinic, Catania, Italy, registered n. 109/2017/PO

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Outcome instruments

VAS-pain

Condition tags

endometriosischronic_pelvic_pain

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (21)

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