A comparison of progestogens or oral contraceptives and gonadotropin-releasing hormone agonists for the treatment of endometriosis: a systematic review

Cherng-Jye Jeng, Cherng‐Jye Jeng, Linus Chuang, Jenta Shen
Expert opinion on pharmacotherapy · 2014 · vol. 15(6) , pp. 767–773 · doi:10.1517/14656566.2014.888414 · PMID:24588662 · W2044647590
review OA: closed CC0 ⤵ 26 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This systematic review of four RCTs found leuprolide comparable to gestrinone, dienogest, and continuous OCs for pain relief but associated with more side effects than progestogens.

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Abstract

OBJECTIVE: This systematic review examined the use of progestogens or oral contraceptives and gonadotropin-releasing hormone (GnRH) agonists for the treatment of endometriosis. RESEARCH DESIGN AND METHODS: Inclusion criteria were: i) randomized controlled trials (RCTs); ii) comparison of progestogens with GnRH agonists for treatment of endometriosis; and iii) endometriosis diagnosed by laparoscopy or laparotomy. MAIN OUTCOME MEASURES: Pelvic pain, bone mineral density, serum estradiol level, and side effects. RESULTS: Of 128 articles identified, there were four RCTs comparing the use of progestogens and GnRH agonists. In three studies a progestogen (gestrinone, lynestrenol, or dienogest) was compared with leuprolide. In one study, ethinyl estradiol/norethindrone was compared with leuprolide/norethindrone. A meta-analysis was not possible as the studies varied markedly in their protocols, inclusion criteria, and the drugs and doses administered. Leuprolide was as effective as gestrinone, dienogest, and continuous oral contraceptives (OCs) for the relief of endometriosis-related pain, whereas it was superior to lynestrenol. Leuprolide was associated with a significant reduction in bone mineral density and estradiol levels and a higher incidence of hot flushes, headaches, mood changes, and vaginal dryness, whereas progestogens were associated with higher incidences of weight gain and acne. CONCLUSIONS: These results suggest that progestogens or OCs may be used as first-line therapy for endometriosis.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Contraceptives, Oral Endometriosis Gonadotropin-Releasing Hormone Progestins Contraceptives, Oral Endometriosis Female Gonadotropin-Releasing Hormone Humans Progestins Randomized Controlled Trials as Topic

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.

References (20)

Cited by (26)

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