子宫内膜异位症相关慢性盆腔疼痛妇女服用复方口服避孕药和地诺孕酮效果的比较研究。

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2024-11-13 DOI:10.1016/j.ejogrb.2024.11.015

Salvatore Caruso , Stefano Cianci , Giuseppe Caruso , Marco Iraci Sareri , Ferdinando Antonio Gulino , Marco Palumbo

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引用次数: 0

摘要

目的比较五种复方口服避孕药（COC）--炔雌醇（EE）30 μg/dienogest (DNG) 2 mg、EE 20 μg/drospirenone (DRSP) 3 mg、17β-雌二醇（E2）1.5 mg/nomegestrol acetate (NomAc) 2.5 mg、雌三醇（E4）15 mg/DRSP 3 mg和戊酸雌二醇（E2V）/DNG - 和 DNG 2 mg，每天用于子宫内膜异位症相关慢性盆腔痛（CPP）、痛经和性生活障碍的妇女：本研究于2018年10月至2023年3月进行。建立了一个数据库，分别收集六个治疗组妇女的数据。使用视觉模拟量表（VAS）测量子宫内膜异位疼痛的程度。3个月和6个月时进行随访：组内分析表明，从基线到 6 个月随访期间，各组的 VAS 评分均有所改善（p 结论：从基线到 6 个月随访期间，各组的 VAS 评分均有所改善：与含有 EE 的 COC 相比，含有 E2 或 E4 的 COC 可以更好地治疗子宫内膜异位症相关疼痛的妇女。它们可能是使用 DNG 的合适替代品，尤其是对不想怀孕的妇女而言。

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Comparative study on the effects of combined oral contraceptives and dienogest in women with endometriosis‑associated chronic pelvic pain

Objective

To compare the effects of five combined oral contraceptives (COCs) – ethinylestradiol (EE) 30 μg/dienogest (DNG) 2 mg, EE 20 μg/drospirenone (DRSP) 3 mg, 17β-estradiol (E2) 1.5 mg/nomegestrol acetate (NomAc) 2.5 mg,estetrol (E4) 15 mg/DRSP 3 mg and estradiol valerate (E2V)/DNG – and DNG 2 mg daily in women with endometriosis-associated chronic pelvic pain (CPP), dysmenorrhea and dyspareunia.

Study design

This study was performed from October 2018 to March 2023. A database was set up to collect data from women in each of the six treatment groups. The level of endometriotic pain was measured using a visual analogue scale (VAS). Follow-up was performed at 3 and 6 months.

Results

The intragroup analysis showed an improvement in the VAS score from baseline to 6-month follow-up for each group (p < 0.001). Intergroup analysis showed that women on COCs containing E2 or E4 had a greater improvement in CCP than women on COCs containing EE (at 3 months, p ≤ 0.001; at 6 months, p ≤ 0.009). Women on E4 15 mg/DRSP 3 mg showed a similar improvement to women on DNG at both 3- and 6-month follow-up, and greater improvement compared with women on COCs containing E2 at 6-month follow-up (p = 0.02). Greater improvement in dysmenorrhea and dyspareunia was seen in women on COCs containing E2 and E4, and DNG compared with women on COCs containing EE (p ≤ 0.001).

Conclusions

COCs containing E2 or E4 could be a better treatment for women with endometriosis-associated pain than COCs containing EE. They may represent a suitable alternative to the use of DNG, particularly for women who do not want to become pregnant.

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.