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

In: Pakistan Journal of Medical and Health Sciences · 2022 · vol. 16(6) , pp. 307–309 · doi:10.53350/pjmhs22166307 · W4285012973
RCT OA: gold CC0 ⤵ 1 in-corpus citation
⚙ AI-generated summary by gemini-2.5-flash-lite, 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 · read from full text ⓘ

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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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).

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Outcome instruments

VAS-pain

Condition tags

endometriosischronic_pelvic_paindyspareunia

Citation neighborhood (2-hop)

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