Effectiveness of Norethisterone Acetate alone Versus in Combination with Letrozole for treatment of Chronic Pelvic Chronic Pain and Dyspareunia in Patients with Endometriosis

Saima Ashraf, Arooj Fatimah Khosa, Rahat Farwa
In: Pakistan Journal of Medical and Health Sciences · 2022 · vol. 16(6) , pp. 307–309 · doi:10.53350/pjmhs22166307 · W4285012973
article OA: gold CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This randomized controlled trial found that combined letrozole and norethisterone acetate significantly reduced chronic pelvic pain and deep dyspareunia in endometriosis patients after six months.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This randomized controlled trial studied 72 women with endometriosis (age 18–60) and baseline pain >5 on a visual analogue scale, comparing 6-month outcomes of norethisterone acetate alone versus norethisterone acetate combined with letrozole. Chronic pelvic pain and deep dyspareunia intensity were measured by VAS at baseline and after 6 months. Mean chronic pelvic pain decreased more in the norethisterone alone group (from ~7 to 1.72) than in the combination group (from ~7 to 4.39), with p<0.001, and deep dyspareunia was reduced in both groups at follow-up. The paper’s main limitation is that it reports only short-term (6-month) follow-up and limited details on randomization and blinding procedures. This paper is centrally about endometriosis — it directly compares norethisterone acetate alone versus with letrozole for chronic pelvic pain and deep dyspareunia in endometriosis patients.

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Abstract

Aim: To compare mean chronic pelvic pain (CPP) and deep dyspareunia intensity after 6 month treatment of using norethisterone acetate alone and combination with letrozole in patients with endometriosis. Study design & duration: This randomized controlled trail was conducted from February 1st, 2020 to January 31st, 2021. Setting: Department of Obs. &Gynecology, Nishtar hospital Multan. Materials and methods: Seventy two women with age range 18-60 years regardless of parity, having endometriosis with baseline pain > 5 at visual analogue scale were included in study. Pain was measured on VAS at baseline and after 6 months of treatment. All data was entered in a pre-designed proforma. Results: Mean age of cases was 39.83 ± 12.61 years in group-A and 41.58 ± 12.66 years in group-B. At baseline the mean chronic pelvic pain in group-A was 7.17 ± 1.28 and in group-B was 7.00 ± 1.39. The mean chronic pelvic pain at 6th month was statistically lower in group-A (1.72 ± 0.74) when compared with group-B (4.39 ± 0.64) with a p-value < 0.001. Similarly, deep dyspareunia was markedly reduced follow-up in both group A and group B at 6 months. Conclusion: CPP and deep dyspareunia are significantly reduced after 6 month of treatment with combined oral letrozole (2.5 mg/day) and norethisterone acetate (2.5 mg/day). Keywords: Endometriosis, aromatase inhibitor, letrozole, norethisterone acetate.

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Outcome instruments

VAS-pain

Condition tags

endometriosischronic_pelvic_paindyspareunia

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