Subcutaneous depot medroxyprogesterone acetate versus leuprolide acetate in the treatment of endometriosis-associated pain

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AI-generated summary by claude@2026-06, 2026-06-07

Subcutaneous depot medroxyprogesterone acetate (104 mg every 3 months) demonstrated equivalent pain reduction to leuprolide for endometriosis and showed significantly less bone mineral density loss.

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Abstract

BACKGROUND: A clinical study compared efficacy and safety of depot medroxyprogesterone acetate (DMPA) with leuprolide for endometriosis-associated pain. METHODS: This multicentre, 18 month, evaluator-blinded, comparator-controlled trial randomized 300 women with laparoscopically diagnosed endometriosis to 6 month treatment with subcutaneous injection of 104 mg/0.65 ml DMPA (DMPA-SC 104) every 3 months or leuprolide (3.75 mg monthly or 11.25 mg every 3 months), with 12 months post-treatment follow-up. Endpoints included patient response to treatment in five signs/symptoms (dysmenorrhoea, dyspareunia, pelvic pain, pelvic tenderness, induration) and changes in bone mineral density (BMD) and productivity at 6 and 18 months. RESULTS: DMPA-SC 104 and leuprolide produced equivalent (P < 0.02) reductions in at least four pain categories and significant (P < 0.001) improvements in composite score at months 6 and 18. At month 6, reductions in total hip and lumbar spine BMD were significantly less (P < 0.001) with DMPA-SC 104 versus leuprolide. BMD returned to pre-treatment levels 12 months post-treatment in the DMPA-SC 104 but not the leuprolide group. Total productivity also significantly (P < or = 0.05) improved in both groups at 6 and 18 months. CONCLUSIONS: DMPA-SC 104 reduces endometriosis-associated pain as effectively as leuprolide and improves productivity with significantly less BMD decline.

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Condition tags

endometriosischronic_pelvic_paindysmenorrheadyspareunia

MeSH descriptors

Antineoplastic Agents, Hormonal Contraceptive Agents, Female Endometriosis Fertility Agents, Female Leuprolide Medroxyprogesterone Acetate Pelvic Pain Uterine Diseases Administration, Cutaneous Adult Antineoplastic Agents, Hormonal Antineoplastic Agents, Hormonal Bone Density Contraceptive Agents, Female Contraceptive Agents, Female Endometriosis Female Fertility Agents, Female Fertility Agents, Female Hip

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europepmc
last seen: 2026-07-02T06:07:54.402228+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
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