Continuous versus cyclic use of oral contraceptives after surgery for symptomatic endometriosis: a prospective cohort study

Nikolaos Vlahos, Nikos Vlahos, Vlachos A, Athanasios Vlachos, Olga Triantafyllidou, Triantafyllidou O, Vitoratos N, Nikolaos Vitoratos, George Creatsas, Creatsas G
Fertility and sterility · 2013 · vol. 100(5) , pp. 1337–1342 · doi:10.1016/j.fertnstert.2013.07.008 · PMID:23953327 · W2140258421
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This prospective cohort study compared continuous and cyclic oral contraceptive use after surgery for symptomatic endometriosis to assess outcomes.

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Abstract

OBJECTIVE: To evaluate the efficacy of continuous oral contraceptive (OC) use versus the usual cyclic fashion in the recurrence of endometriosis-related symptoms after surgery. DESIGN: Prospective cohort trial involving patients in two tertiary care units. SETTING: Academic institution in collaboration with a private hospital. PATIENT(S): 356 patients underwent surgical treatment by laparoscopy for symptomatic endometriosis. INTERVENTION(S): After surgical treatment for endometriosis, patients offered 6-month course of cyclic OC (including a 7-day pill-free period) or continuous OC. MAIN OUTCOME MEASURE(S): Recurrence rate of endometriosis-related symptoms and endometriomas after fertility-sparing surgery. RESULT(S): Out of 356 patients, 167 were placed on the usual cyclic OC course and 85 on continuous OC for a minimum of 6 months. The continuous OC group experienced a statistically significant reduction in recurrence rates for endometrioma, dysmenorrhea, and non-menstrual pelvic pain as compared with the cyclic OC group. There was no reduction in the recurrence of dyspareunia between the two groups. CONCLUSION(S): After surgical treatment of endometriosis, the use of both cyclic and continuous OC improves pain symptoms when compared with preoperative scores. Continuous OC appears to be associated with a reduced recurrence rate for dysmenorrhea, non-menstrual pelvic pain, and endometrioma but not for dyspareunia as compared with cyclic OC.

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Condition tags

dysmenorrheaendometriosischronic_pelvic_pain

MeSH descriptors

Contraceptives, Oral, Hormonal Contraceptives, Oral, Sequential Endometriosis Fertility Preservation Fertility Preservation Fertility Preservation Laparoscopy Laparoscopy Laparoscopy Adult Adult Chi-Square Distribution Chi-Square Distribution Contraceptives, Oral, Hormonal Contraceptives, Oral, Hormonal Contraceptives, Oral, Sequential Contraceptives, Oral, Sequential Drug Administration Schedule Drug Administration Schedule Dysmenorrhea

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (29)

Cited by (39)

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