Combined effect of letrozole and dydrogesterone versus dydrogesterone alone for relieving pain in patients with endometriosis

Background Endometriosis is a medical condition in women caused by the growth of active endometrial tissue outside the uterine cavity. It predominantly affects women of reproductive age and typically manifests as dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. It negatively impacts psychological well-being and health-related quality of life. Aim This study aims to compare the effect of the combination of letrozole and dydrogesterone versus the effect of dydrogesterone alone in pain-associated endometriosis Patients & Methods This randomized controlled study was conducted on 88 women with endometriosisassociated pain in the gynecologic outpatient clinic at Tanta University Hospitals, from October 2023 to September 2024. Patients were randomly divided into two equal groups, with 44 patients in each group. In the 1st group, Dydrogesterone (10 mg) twice daily and Letrozole (2.5 mg) once daily were administered from the 2nd day of menses continuously for 3 months. In the second group, Dydrogesterone (10 mg) was administered twice daily from the 2nd day of menses continuously for 3 months. The effectiveness of treatment was assessed by relief of symptoms. VAS, serum Estradiol, and CA 125 levels were measured before and after treatment. Results The mean age of patients was 30.11 ± 6.93 years in 1st group and 31.84 ± 7.98 years in 2nd group. Clinical effectiveness of treatment was significant in both groups but significantly better in the 1st group (40 patients, 90.90%) than the 2nd group (31 patients, 70.45%) (P value