Ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen for the management of endometriosis-associated pelvic pain: a randomized controlled trial
RCT
OA: hybrid
CC0
⤵ 68 in-corpus citations
AI-generated summary
Ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen significantly reduced endometriosis-associated pelvic pain compared to placebo and improved related symptoms.
One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works
Abstract
OBJECTIVE: To investigate the efficacy and safety of ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen (FlexibleMIB) compared with placebo to treat endometriosis-associated pelvic pain (EAPP).
DESIGN: A phase 3, randomized, double-blind, placebo-controlled, parallel-group study, consisting of a 24-week double-blind treatment phase followed by a 28-week open-label extension phase with an unblinded reference arm.
SETTING: Thirty-two centers.
PATIENT(S): A total of 312 patients with endometriosis.
INTERVENTION(S): Patients were randomized to FlexibleMIB, placebo, or dienogest. The FlexibleMIB and placebo arms received 1 tablet per day continuously for 120 days, with a 4-day tablet-free interval either after 120 days or after ≥3 consecutive days of spotting and/or bleeding on days 25-120. After 24 weeks, placebo recipients were changed to FlexibleMIB. Patients randomized to dienogest received 2 mg/d for 52 weeks in an unblinded reference arm.
MAIN OUTCOME MEASURE(S): Absolute change in the most severe EAPP based on visual analog scale scores from the baseline observation phase to the end of the double-blind treatment phase.
RESULT(S): Compared with placebo, FlexibleMIB significantly reduced the most severe EAPP (mean difference in visual analog scale score: -26.3 mm). FlexibleMIB also improved other endometriosis-associated pain and gynecologic findings and reduced the size of endometriomas.
CONCLUSION(S): FlexibleMIB improved EAPP and was well tolerated, suggesting it may be a new alternative for managing endometriosis.
CLINICAL TRIALS REGISTRATION NUMBER: NCT01697111.
My notes (saved in your browser only)
Condition tags
MeSH descriptors
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 (49)
- ACOG Updates Guideline on Diagnosis and Treatment of Endometriosis via openalex
- Continuous use of an oral contraceptive for endometriosis-associated recurrent dysmenorrhea that does not respond to a cyclic pill regimen via openalex
- Continuous versus cyclic oral contraceptives after laparoscopic excision of ovarian endometriomas: a systematic review and metaanalysis via openalex
- Defining a minimal clinically important difference for endometriosis-associated pelvic pain measured on a visual analog scale: analyses of two placebo-controlled, randomized trials via openalex
- Dienogest in long-term treatment of endometriosis via openalex
- Endometriosis and infertility: a committee opinion via openalex
- Endometriosis and infertility: epidemiology and evidence-based treatments via openalex
- Epidemiology of endometriosis via openalex
- Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries via openalex
- Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric, and lifestyle factors via openalex
- Low-dose oral contraceptive pill for dysmenorrhea associated with endometriosis: a placebo-controlled, double-blind, randomized trial via openalex
- Management of pelvic pain from dysmenorrhea or endometriosis via openalex
- Safety of medical treatments for endometriosis via openalex
- Surgical treatment of endometriosis: a 7-year follow-up on the requirement for further surgery via openalex
- The impact of endometriosis upon quality of life: a qualitative analysis via openalex
- 'Waiting for Godot': a commonsense approach to the medical treatment of endometriosis via openalex
- W2127964780 via openalex
- W2128914859 via openalex
- W2132577372 via openalex
- W2138176364 via openalex
- W2140707981 via openalex
- W2147486481 via openalex
- W2151428696 via openalex
- W2154381405 via openalex
- W2163315477 via openalex
- W2175100915 via openalex
- W2277748650 via openalex
- W4297913658 via openalex
- W6605204045 via openalex
- W6679100095 via openalex
- W6680665938 via openalex
- W6687828466 via openalex
- W88548575 via openalex
- W6740200389 via openalex
- W106352447 via openalex
- W129985863 via openalex
- W1968397374 via openalex
- W1989556987 via openalex
- W2005946098 via openalex
- W2015806567 via openalex
- W2022932023 via openalex
- W2036777235 via openalex
- W2042557590 via openalex
- W2067684274 via openalex
- W2068737752 via openalex
- W2069392551 via openalex
- W2114720923 via openalex
- W2124120026 via openalex
- W2126908963 via openalex
Cited by (50)
- Description of a case of endometriosis associated with a bicornuate uterus: Role of uterine malformations in endometriosis 2026
- HORMONAL THERAPIES FOR ENDOMETRIOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED HEAD-TO-HEAD TRIALS 2026
- The Microbiota-Endometriosis Axis: An Immune-Endocrine Integration Model and Emerging Therapeutic Targets 2026
- The role of pharmacotherapy in the treatment of endometriosis: an update 2025
- Safety of current strategies to manage moderate to severe pain in patients with endometriosis 2025
- Pharmacologic Interventions for Endometriosis-Related Pain: A Systematic Review and Meta-analysis 2025
- Dienogest vs. combined oral contraceptive: A systematic review and meta-analysis of efficacy and side effects to inform evidence-based guidelines 2025
- The Impact of Nutrition on Endometriosis Complaints in Patients Using and Not Using Hormone Therapy 2025
- Comparison of dienogest or combinations with ethinylestradiol/estradiol valerate on the pain score of women with endometriosis: A prospective cohort study 2024
- Neuroimmunology of Endometriosis-Associated Pain and Its Psychological Aspects 2024
- Safety and efficacy of pharmacotherapies for pelvic inflammatory disease and endometriosis 2024
- A systematic literature review on patient-reported outcome domains and measures in nonsurgical efficacy trials related to chronic pain associated with endometriosis: an urgent call to action 2024
- Assessing the impact of hormonal contraceptive use on menstrual health among women of reproductive age - a systematic review 2024
- Horizons in Endometriosis: Proceedings of the Montreux Reproductive Summit, 14-15 July 2023 2024
- The reporting quality and spin of randomized controlled trials of endometriosis pain: Methodological study based on CONSORT extension on abstracts 2024
- Contraception et endométriose 2024
- Progesterone resistance in endometriosis: A pathophysiological perspective and potential treatment alternatives 2024
- Long-term therapy with dienogest or other oral cyclic estrogen-progestogen can reduce the need for ovarian endometrioma surgery 2024
- Outpatient diagnosis and drug therapy of endometriosis: A review 2024
- Experience of using drospirenone/ethinyl estradiol combination in women of reproductive age 2024
- Management of endometriosis: a call to multidisciplinary approach 2024
- ABORDAGENS CONTEMPORÂNEAS PARA A GESTÃO DA ENDOMETRIOSE 2024
- The Efficacy of Medical Treatment on Endometrioma: A Systematic Review and Meta-Analysis 2024
- Clinical and sonographic impact of oral contraception in patients with deep endometriosis and adenomyosis at 2 years of follow-up 2023
- MRI of endometriosis 2023
- Endometriose 2023
- Aktuelle Aspekte der endokrinen Therapie der Endometriose und der Adenomyose 2023
- Medical Management of Ovarian Endometriomas: A Systematic Review and Meta-analysis 2023
- Progestins and combined oral contraceptives in the hormonal treatment of endometriosis – a review 2023
- Estro-Progestins and Pain Relief in Endometriosis 2022
- Medical treatments of endometriosis: a review 2022
- Hormonal Therapy in Endometriosis and Adenomyosis: Oral Contraceptives 2022
- Genomic Evidence Supports the Recognition of Endometriosis as an Inflammatory Systemic Disease and Reveals Disease-Specific Therapeutic Potentials of Targeting Neutrophil Degranulation 2022
- Saliva microRNA signature to diagnose endometriosis: A cost-effectiveness evaluation of the Endotest® 2022
- Clinical practice guidelines for endometriosis in Japan (The 3rd edition) 2022
- Deciding on the appropriate pharmacotherapy for the treatment of endometriosis 2022
- Quality of Life in Japanese Patients with Dysmenorrhea or Endometriosis-Associated Pelvic Pain Treated with Extended Regimen Ethinylestradiol/Drospirenone in a Real-World Setting: A Prospective Observational Study 2022
- The ENDOPAIN 4D Questionnaire: A New Validated Tool for Assessing Pain in Endometriosis 2021
- Assessment of Quality of Life, Sexual Quality of Life, and Pain Symptoms in Deep Infiltrating Endometriosis Patients With or Without Associated Adenomyosis and the Influence of a Flexible Extended Combined Oral Contraceptive Regimen: Results of a Prospective, Observational Study 2021
- Medical management of endometriosis 2021
- An assessment of the efficacy and safety of dydrogesterone in women with ovarian endometrioma: An open-label multicenter clinical study 2021
- Non-contraceptive Benefits of Hormonal Methods 2021
- Potential Therapeutic Options and Perspectives for Alleviation of Endometrial Estrogen Dominance and Progesterone Resistance in Endometriosis 2021
- Systematic review and Meta-analysis of efficacy and safety of dienogest in treatment of endometriosis 2021
- Pharmacological Management of Endometriosis-related Pain: The Expert Opinion 2021
- Chronic pelvic pain in patients of reproductive age with endometriosis 2021
- Endometriosis: a guide to investigations and treatment in the emergency department 2021
- Tolerability considerations for gonadotropin-releasing hormone analogues for endometriosis 2020
- Effect of Dienogest therapy on the size of the endometrioma 2020
- Medical management of endometriosis: what the radiologist needs to know 2020
Source provenance
- europepmc
- last seen: 2026-10-21T06:16:17.486033+00:00
- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-10-08T21:20:36.982799+00:00
License: CC0
· commercial use OK