Progestogen-only contraceptive pill compared with combined oral contraceptive in the treatment of pain symptoms caused by endometriosis in patients with migraine without aura
Abstract
Objective Evaluate patient satisfaction at 6-month treatment in women with symptomatic rectovaginal endometriosis and migraine without aura with (progestogen-only contraceptive pill, POP versus sequential combined oral contraceptives, COC) STUDY DESIGN: A patient preference trial including 144 women (82 in the group COC and 62 in the group POP). Main outcome measure was the degree of patient satisfaction by using a Likert scale. Secondary objectives were to evaluate differences in endometriosis-related pain and changes in migraine features during the treatment.Results In group POP, 38/62 women (61.2%) were satisfied or very satisfied after treatment, compared to 31/82 women (37.8%) in group COC (p=0.005). The intensity of chronic pelvic pain and dyspareunia significantly decreased at 6-month treatment in both the groups. At 6-month treatment, the number of migraine attacks was lower than at baseline in group POP (p=0.002), while it was not reduced in group COC (p=0.521). The intensity of migraine attacks was significantly different between baseline and 6-month treatment in group POP (p<0.001) but not in group COC (p=0.078).Conclusions POP is better tolerated than COC and it seems to ameliorate migraine attacks compared to COC in symptomatic patients with rectovaginal endometriosis and migraine without aura. Both drugs efficaciously relieve endometriosis-related pain symptoms. This study supports the use of the POP in women with rectovaginal endometriosis and coexisting migraine without aura.
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Despite some limited drawbacks in terms of efficacy and tolerability, OC could retain its role in the current therapeutic armamentarium for women with endometriosis.
“Thus, despite some limited drawbacks in terms of efficacy and tolerability (34,67), OC could retain its role in the current therapeutic armamentarium for women with endometriosis (77,78).”
From A stepped-care approach to symptomatic endometriosis management: A participatory research initiative (2018) · cites this paper as [34]
Progestins can be safely used in women with contraindication to estrogens or who do not tolerate estrogens.
“can be safely used in those women with contraindication to estrogens [11] or in those who do not tolerate estrogens [12].”
From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [12]
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- Authors
- Morotti, M., Remorgida, V., Venturini, P. L., & Ferrero, S.
- Affiliations
- Ospedale Policlinico San Martino (IT)
- Venue
- European Journal of Obstetrics & Gynecology and Reproductive Biology
- Publisher
- Elsevier BV
- Published
- 2014-08
- Volume
- 179
- Pages
- 63-68
- ISSN
- 0028-2243 (ISSN-L)
- 0301-2115
- OpenAlex
- W1966091296
- Cited by
- 72
- References
- 35
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 7 · 2023: 9 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 13 · 2017: 7 · 2016: 5 · 2015: 4 · 2014: 3
- FWCI
- 7.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- European Journal of Obstetrics & Gynecology and Reproductive Biology (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Keywords
- combined oral contraceptives, endometriosis, rectovaginal endometriosis, migraine without aura, endometriosis-associated pain, dyspareunia, patient satisfaction, migraine frequency, chronic pelvic pain, hormonal contraception
- MeSH terms
- Adult, Analgesics, Contraceptives, Oral, Combined, Endometriosis, Female, Humans, Progestins, Treatment Outcome, Pelvic Pain, Migraine without Aura
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