Progestagens and anti-progestagens for pain associated with endometriosis

A Prentice, Prentice A, Sari Kives, A J Deary, Alison Deary, Julie Brown, Andrew Prentice, Bland E, E Bland, Elaine Bland
The Cochrane database of systematic reviews · 2000 · pp. CD002122 · doi:10.1002/14651858.cd002122 · PMID:10796864 · W4233835377
Systematic review / meta-analysis OA: closed CC0 ⤵ 58 in-corpus citations
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This review of seven trials found that progestagens and the anti-progestagen gestrinone are effective treatments for endometriosis-associated pain, though continuous progestagens are more effective than those given in the luteal phase.

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Abstract

BACKGROUND: Endometriosis is a gynaecological condition that presents either with the problem of infertility or with painful symptoms. The clinical observation of an apparent resolution of symptoms during pregnancy gave rise to the concept of treating patients with a pseudo-pregnancy regime. Initially combinations of high dose oestrogens and progestagens were used but this was subsequently replaced by progestogens alone. More recently progestogens of both progestagens and anti-progestagens in the treatment of symptomatiprogestogenssis OBJECTIVES: To determine the effectiveness of both the progestagens and anti-progestagens in the treatment of painful symptoms ascribed to the diagnosis of endometriosis. SEARCH STRATEGY: The search strategy of the Menstrual Disorders and Subfertility Group was utilised to identify all publications which described or might have described randomised trials of any progestagen or any anti-progestagen in the treatment of symptomatic endometriosis. SELECTION CRITERIA: Trials were included if they were randomised and considered the effectiveness of either a progestagen or an anti-progestagen in the treatment of painful symptoms associated with endometriosis. DATA COLLECTION AND ANALYSIS: Seven studies were considered to be appropriate for inclusion in this review. Only three studies evaluating progestagens were included (comparison with placebo, danazol and oral contraceptive plus danazol). All other studies compared the anti-progestagen, gestrinone, with other medical therapies. MAIN RESULTS: Progestagens appear to be an effective therapy for the painful symptoms associated with endometriosis. Gestrinone is as effective as other established medical therapies (danazol and GnRH analogues). REVIEWER'S CONCLUSIONS: The limited available data suggests that both continuous progestagens and anti-progestagens are effective therapies in the treatment of painful symptoms associated with endometriosis. Progestagens given in the luteal phase are not effective. These conclusions should be accepted cautiously due to a lack of data.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Progesterone Congeners Progestins Dydrogesterone Dydrogesterone Dydrogesterone Endometriosis Endometriosis Endometriosis Female Female Gestrinone Gestrinone Gestrinone Humans Humans Medroxyprogesterone Acetate Medroxyprogesterone Acetate Medroxyprogesterone Acetate Pain

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (34)

Cited by (50)

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