Progestins for Symptomatic Endometriosis: Results of Clinical Studies

Stefano Angioni, Vito Cofelice, Federica Sedda, Emanuela Loi, Francesco Multinu, Alessandro Pontis, Gian Benedetto Melis
In: Current Drug Therapy · 2015 · vol. 10(2) , pp. 91–104 · doi:10.2174/157488551002151222160051 · W2894577753
article OA: closed CC0 ⤵ 14 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Progestins are safe, effective, and well-tolerated first-line medical treatments for symptomatic endometriosis, despite challenges in comparative analysis due to study limitations.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-09 · read from full text ⓘ

This paper systematically searched PubMed (1980–2015) for clinical studies assessing progestin-based medical therapy for symptomatic endometriosis, including trials and observational designs across drugs such as cyproterone acetate, norethisterone acetate, medroxyprogesterone acetate, levonorgestrel, etonogestrel, dienogest, and selective progesterone receptor modulators. The authors report that comparative interpretation is limited by the lack of a standardized instrument for painful symptoms and by the predominance of small, retrospective, and uncontrolled studies, which prevents definitive conclusions. Despite these limitations, the review concludes that progestins are generally safe, effective, and well tolerated. This paper is centrally about endometriosis — it reviews clinical studies of progestins used as primary or adjunct therapy for symptomatic endometriosis and highlights limitations due to nonstandard pain outcome measures.

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Abstract

Progestins, which are synthetic progestational compounds, have been used in the management of symptomatic endometriosis, both as primary therapy and as an adjunct to surgery. Several oral compounds have been used for this purpose, and different degrees of benefits have been shown. The lack of a standardized instrument to evaluate painful symptoms makes comparative analysis very difficult. We performed a systematic search of the Pubmed database from January 1980 to January 2015. The database used the term “endometriosis” as the relevant medical subject heading; selected sub- headings were “progestins”, “medical therapy”, “review” and “randomized controlled trials”, “controlled trials”, “case-control studies”, and “descriptive studies”. We aimed to review all available trials in order to investigate the medical treatment of endometriosis solely with progestins, with special attention to pharmacodynamic activity. The drugs studied were cyproterone acetate, norethisterone acetate, medroxyprogesterone acetate, levonorgestrel, etonogestrel, dienogest, and selective progesterone receptor modulators. However, it is very difficult to reach a definitive conclusion because most trials were small, retrospective, and uncontrolled. Nevertheless, it is clear that progestins are generally safe, effective, and well tolerated and should be considered as the first line of medical treatment in symptomatic endometriosis provided the patients have no desire for pregnancy. Keywords: Cyproterone acetate, dienogest, dysmenorrhea, endometriosis, etonogestrel, levonorgestrel, medroxyprogesterone acetate, norethisterone acetate, pelvic pain, progestins.
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Abstract

Progestins, which are synthetic progestational compounds, have been used in the management of symptomatic endometriosis, both as primary therapy and as an adjunct to surgery. Several oral compounds have been used for this purpose, and different degrees of benefits have been shown. The lack of a standardized instrument to evaluate painful symptoms makes comparative analysis very difficult. We performed a systematic search of the Pubmed database from January 1980 to January 2015. The database used the term “endometriosis” as the relevant medical subject heading; selected sub- headings were “progestins”, “medical therapy”, “review” and “randomized controlled trials”, “controlled trials”, “case-control studies”, and “descriptive studies”. We aimed to review all available trials in order to investigate the medical treatment of endometriosis solely with progestins, with special attention to pharmacodynamic activity. The drugs studied were cyproterone acetate, norethisterone acetate, medroxyprogesterone acetate, levonorgestrel, etonogestrel, dienogest, and selective progesterone receptor modulators. However, it is very difficult to reach a definitive

Conclusion

because most trials were small, retrospective, and uncontrolled. Nevertheless, it is clear that progestins are generally safe, effective, and well tolerated and should be considered as the first line of medical treatment in symptomatic endometriosis provided the patients have no desire for pregnancy.

Keywords

Cyproterone acetate, dienogest, dysmenorrhea, endometriosis, etonogestrel, levonorgestrel, medroxyprogesterone acetate, norethisterone acetate, pelvic pain, progestins. 71 1 1

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Condition tags

endometriosisdysmenorrhea

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.

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