Continuous versus cyclic oral contraceptives for the treatment of endometriosis: a systematic review

Konstantinos A Zorbas, Konstantinos P Economopoulos, Nikolaos Vlahos, Nikos F Vlahos
Archives of gynecology and obstetrics · 2015 · vol. 292(1) , pp. 37–43 · doi:10.1007/s00404-015-3641-1 · PMID:25644508 · W1971961099
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Continuous oral contraceptives after endometriosis surgery reduced dysmenorrhea recurrence, delayed symptom onset, and decreased endometrioma recurrence compared to cyclic use.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This systematic review examined whether continuous versus cyclic combined oral contraceptive regimens after conservative surgery reduce symptom recurrence and improve patient compliance in women with endometriosis, using a Medline search to identify four eligible studies with at least 6 months of treatment and 12 months of follow-up. The authors’ cumulative, descriptive analysis found that postoperative continuous oral contraceptives were associated with lower dysmenorrhea recurrence, delayed return of dysmenorrhea, reduced nonspecific pelvic pain, and reduced endometrioma recurrence. The major limitation stated by the authors is that only four studies met strict inclusion criteria and the review used a purely descriptive approach rather than inferential analysis. This paper is centrally about endometriosis — it systematically compares continuous versus cyclic postoperative oral contraceptive regimens to reduce endometriosis symptom and lesion recurrence.

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Abstract

PurposeRecurrence of endometriosis after conservative surgery has been observed in 40-50 % of patients within the first 5 years. A variety of regimens such as combined oral contraceptives, GnRH agonists, danazol, and progestins have been used postoperatively to reduce recurrence rates. Oral contraceptives (oCP) have been used either in a cyclic or in a continuous (no pill-free interval) fashion. The purpose of this article was to summarize the existing evidence on the efficacy and patient compliance for the use of oCP in a continuous versus cyclic fashion following conservative surgery for endometriosis.MethodsA systematic search of Medline identified four eligible studies. Studies were considered eligible, if they have evaluated oCP therapy, either in a cyclic or continuous regimen, after conservative surgery for endometriosis. Specifically, studies (1) reporting on women with endometriosis who were treated postoperatively with both continuous oCP and cyclic oCP, (2) written in English, (3) with minimum 6 months duration of medical treatment, and (4) with minimum 12 months duration of follow-up were considered eligible for our systematic review. Outcome measures of these eligible studies were tabulated and then analyzed cumulatively. A purely descriptive approach was adopted concerning all variables.ResultsPostoperative use of continuous oCP was associated with a reduction in the recurrence rate of dysmenorrhea, delay in the presentation of dysmenorrhea, reduction in nonspecific pelvic pain, and reduction in the recurrence rate for endometrioma.ConclusionsUse of oCP in a continuous fashion following conservative surgery for endometriosis is more beneficial to cyclic use.
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Abstract

Purpose Recurrence of endometriosis after conservative surgery has been observed in 40–50 % of patients within the first 5 years. A variety of regimens such as combined oral contraceptives, GnRH agonists, danazol, and progestins have been used postoperatively to reduce recurrence rates. Oral contraceptives (oCP) have been used either in a cyclic or in a continuous (no pill-free interval) fashion. The purpose of this article was to summarize the existing evidence on the efficacy and patient compliance for the use of oCP in a continuous versus cyclic fashion following conservative surgery for endometriosis.

Methods

A systematic search of Medline identified four eligible studies. Studies were considered eligible, if they have evaluated oCP therapy, either in a cyclic or continuous regimen, after conservative surgery for endometriosis. Specifically, studies (1) reporting on women with endometriosis who were treated postoperatively with both continuous oCP and cyclic oCP, (2) written in English, (3) with minimum 6 months duration of medical treatment, and (4) with minimum 12 months duration of follow-up were considered eligible for our systematic review. Outcome measures of these eligible studies were tabulated and then analyzed cumulatively. A purely descriptive approach was adopted concerning all variables.

Results

Postoperative use of continuous oCP was associated with a reduction in the recurrence rate of dysmenorrhea, delay in the presentation of dysmenorrhea, reduction in nonspecific pelvic pain, and reduction in the recurrence rate for endometrioma.

Conclusions

Use of oCP in a continuous fashion following conservative surgery for endometriosis is more beneficial to cyclic use. Similar content being viewed by others

References

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Author information Authors and Affiliations Corresponding author Electronic supplementary material Below is the link to the electronic supplementary material. Rights and permissions About this article Cite this article Zorbas, K.A., Economopoulos, K.P. & Vlahos, N.F. Continuous versus cyclic oral contraceptives for the treatment of endometriosis: a systematic review. Arch Gynecol Obstet 292, 37–43 (2015). https://doi.org/10.1007/s00404-015-3641-1 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-015-3641-1

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Condition tags

dysmenorrheaendometriosischronic_pelvic_pain

MeSH descriptors

Contraceptives, Oral Contraceptives, Oral, Combined Endometriosis Contraceptives, Oral Contraceptives, Oral Contraceptives, Oral, Combined Contraceptives, Oral, Combined Dysmenorrhea Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Female Humans Pelvic Pain Pelvic Pain Pelvic Pain Postoperative Period Recurrence

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