Efficacy of estetrol (E4) 15 mg/ drospirenone (DRSP) 3 mg combination for the treatment of dysmenorrhea in women with recurrent endometriosis and/or adenomyosis

Ya-Shun Lo, Lo YS, Le-Tien Hsu, Hsu LT, Wu HM, Hsien-Ming Wu, Hong-Yuan Huang, Huang HY
Taiwanese journal of obstetrics & gynecology · 2026 · vol. 65(6) , pp. 1106–1109 · doi:10.1016/j.tjog.2025.10.021 · PMID:42951459 · W7224096790
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In a retrospective study of 14 women with recurrent endometriosis or adenomyosis, estetrol and drospirenone significantly reduced dysmenorrhea pain severity and improved quality of life while maintaining a favorable safety profile.

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Abstract

OBJECTIVE: To evaluate the efficacy and safety of a combined oral contraceptive containing estetrol (E4) 15 mg and drospirenone (DRSP) 3 mg in the treatment of dysmenorrhea associated with recurrent endometriosis and/or adenomyosis. MATERIALS AND METHODS: This retrospective observational study reviewed the medical records of 23 women undergoing E4/DRSP treatment. Among them, 14 patients with recurrent endometriosis and/or adenomyosis who completed at least 16 weeks of treatment were analyzed. The primary outcome was the change in endometriosis-associated pain severity, assessed using a visual analogue scale (VAS). Secondary outcomes included changes in serum estradiol and cancer antigen 125 (CA-125) levels, as well as patient-reported quality of life. Biochemical data were available for 11 patients. Statistical analysis was performed using paired t-tests, with significance defined as p < 0.05. RESULTS: The mean baseline VAS score was 7.7 with 95% confidence interval (CI) 6.9 to 8.6, which decreased significantly to 3.3 (95% CI, 2.3 to 4.3) after treatment (p < 0.005). The average VAS responder rate was 55.8%, with 85.7% of patients achieving a ≥30% reduction and defined as responder. Serum estradiol levels significantly declined (p = 0.024), from 214 pg/ml (95%CI, 34.7-394.1 pg/ml) to 42.7 pg/ml (95% CI, 2.23-83.2 pg/ml), whereas CA-125 showed a nonsignificant downward trend. No serious adverse events occurred. A total of 86% of patients reported improved quality of life. CONCLUSION: The E4/DRSP combination regimen appears to be an effective and well-tolerated treatment for dysmenorrhea in women with recurrent endometriosis and/or adenomyosis. It may serve as a viable long-term hormonal option, for those intolerant or have contraindications to conventional therapies.

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MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Androstenes Androstenes Androstenes Androstenes Androstenes Androstenes Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Contraceptives, Oral, Combined Dysmenorrhea

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References (15)

SciLite annotations

chemicals 6
estetrol drospirenone estetrol drospirenone estradiol estradiol

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