Effect of Oral Contraceptive Pills on Chronic Pelvic Pain Associated with Endometriosis

Background: Endometriosis is a prevalent etiology of chronic pelvic pain (CPP) in reproductive-age females. Combined oral contraceptive pills (OCPs) are widely utilized as first-line therapy due to their efficacy, safety, and tolerability.Aim: To study the efficacy of oral contraceptive pills on chronic pelvic pain related to endometriosis.Patients and methods: This Prospective randomized clinical trial research has been performed on 60 cases and selected from the outpatient clinic of obstetrics and gynecology at Al-Hussein University Hospital from November 2024 to April 2025.Results: Baseline characteristics were comparable except for parity. The OCP group showed significantly greater reduction in VAS score at 12 weeks (3.73 ± 1.08 vs 5.13 ± 1.10) and 24 weeks (2.5 ± 0.93 vs 5.0 ± 1.28) (p<0.001), with 58.4% mean pain improvement versus 17.2% in placebo. Significant improvements were also observed in dysmenorrhea, dyspareunia, pelvic tenderness, and induration (all p≤0.001). Side effects were mild and acceptable.Conclusion: Continuous use of ethinyl estradiol/drospirenone for 24 weeks is highly effective and well-tolerated in decreasing chronic pelvic pain and related symptoms in females with endometriosis.