Oral contraceptives for endometriosis associated pain

Mohamed Abdelhafez Saad Swailum


Abstract


Endometriosis is a common gynecological condition which affects many women of reproductive age worldwide and is a major cause of pain and infertility. Endometriosis is classically defined as the presence of endometrial glands and stroma in ectopic locations outside of the endometrial cavity, primarily the pelvic peritoneum, ovaries, and rectovaginal septum and often of progressive nature. Endometriosis is a chronic disease affecting at least 10% of reproductive-aged women, but is found in approximately 40% of infertile women, and up to 90% of women with pelvic pain. The classic triad of endometriosis symptoms, dysmenorrhea, dyspareunia, and dyschesia, raises clinical suspicion for this disorder. Medical and surgical treatments are mainstays in the management of endometriosis, and different approaches are dictated by the pleiotropic manifestations of the disease as well as underlying patient characteristics. In general, medical treatment options are limited when fertility is desired because of the ovarian suppression inherent in their mechanisms of action. The medical treatment options for endometriosis rely on the suppression of endometriosis by manipulating the hormonal milieu because endometriosis growth and activation are stimulated by estrogen, and both estrogen and progesterone receptors are present in ectopic endometrial tissue. Hormonal contraceptives containing both ethinyl estradiol (EE) and progestin can be used in a cyclic or continuous fashion for the treatment of endometriosis. Continuous use appears to result in better pain control. The study patients were recruited from women attending outpatient clinic at (Ain-Shams University Maternity Hospital). Seventy women of reproductive age who complained of symptoms referred to the diagnosis of endometriosis were randomly assigned as patient and placebo group those will receive (OCPs + NSAID's) and (Tri-B tablets + NSAID's) as a placebo in continues pattern for four successive cycles, respectively. Primary outcome measures were improvement of pain symptoms of endometriosis: dysmenorrhea, dyspareunia non-menstrual pain and improvement of any other pain symptom of endometriosis such as (Post-coital pain, dyschezia and/or cyclical pain not associated with menstruation), also measurement of any side effects occurring during therapy (including pregnancy). After four month of therapy, Pain was reassessed at the end of treatment for each of the three symptoms. Also recurrence, frequency of pain and the use of pain killers were reassessed at end of treatment. The numbers of women at trial entry and at the end of treatment who had either no pain or any pain (mild, moderate or severe) were calculated from the data presented. The present study clearly demonstrated that continues use of low dose OCPs are an effective treatment for pain associated with endometriosis with few adverse effects in women who did not wish to get pregnant in the near future.


Other data

Other Titles حبوب منع الحمل لعلاج الَالاَم المصاحبة لمرض بطانة الرحم المهاجرة
Issue Date 2017
URI http://research.asu.edu.eg/handle/12345678/2544


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