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Cited by 103Endometriosis Research and TreatmentEctopic Pregnancy Diagnosis and ManagementMenstrual Health and Disorders

Add-back therapy in the treatment of endometriosis-associated pain

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Zupi, Errico, Marconi, Daniela, Sbracia, Marco, Zullo, Fulvio, De Vivo, Bonaventura, Exacustos, Caterina, Sorrenti, Giuseppe·2004·Fertility and Sterility
DOI 10.1016/j.fertnstert.2004.03.062
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Abstract

Objective To determine the efficacy of GnRH analogue plus add-back therapy compared with GnRH analogue alone and estroprogestin in patients with relapse of endometriosis-associated pain.Design Randomized, controlled study.Setting University hospital.Patient(s) One hundred thirty-three women with relapse of endometriosis-related pain after previous endometriosis surgery.Intervention(s) Forty-six women were treated with GnRH analogue plus add-back therapy, 44 women were given GnRH analogue alone, and 43 women received estroprogestin, for 12 months.Main outcome measure(s) Pain evaluation by a visual analogue scale, quality of life in treated patients according to the SF-36 questionnaire, and occurrence of adverse effects, including bone mass density loss, at pretreatment, after 6 months of treatment, at the end of treatment (12 months), and 6 months after discontinuation of treatment.Result(s) Patients treated either with GnRH analogue alone or GnRH analogue plus add-back therapy showed a higher reduction of pelvic pain, dysmenorrhea, and dyspareunia than patients treated with oral contraceptive, whereas patients treated with add-back therapy showed a better quality of life, as assessed with the SF-36 questionnaire, and adverse effects rate than the other two groups.Conclusion(s) Add-back therapy allows the treatment of women with relapse of endometriosis-associated pain for a longer period, with reduced bone mineral density loss, good control of pain symptoms, and better patient quality of life compared with GnRH analogue alone or oral contraceptive.

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  • COCs after previous surgery have similar or less efficacy in pain relief than GnRH-a.

    “However, COCs after previous surgery has similar [258] or less efficacy in pain relief than GnRH-a [259].”

    From Hormonal treatments for endometriosis: The endocrine background (2022) · cites this paper as [259]

  • GnRHa plus add-back therapy improves health-related quality of life in women with recurrent or intractable endometriosis-related pain.

    “GnRHa plus add-back therapy improved HRQoL in women with recurrent [22] or intractable endometriosis-related pain [28].”

    From Health-related quality of life in women with endometriosis: a systematic review (2012) · cites this paper as [22]

  • Add-back hormonal therapy is better than GnRHa alone at improving health-related quality of life at 3 and 12 months of treatment and at 6 months post-treatment.

    “when compared with GnRHa alone, add-back hormonal therapy was better at improving the HRQoL at both 3 and 12 months of treatment and at 6 months post-treatment [22].”

    From Health-related quality of life in women with endometriosis: a systematic review (2012) · cites this paper as [22]

  • Twelve months of add-back therapy produces better pain control, physical function and vitality than oral contraceptives in patients with pain relapse after conservative surgery.

    “When considering OCs versus GnRHa plus add-back therapy, 12 months of add-back therapy was reported to produce better pain control, physical function and vitality in patients with pain relapse after conservative surgery [22].”

    From Health-related quality of life in women with endometriosis: a systematic review (2012) · cites this paper as [22]

  • Twelve months of oral contraceptive therapy fails to improve health-related quality of life in women with recurrent pelvic pain, with symptoms relapsing after discontinuation.

    “However, Zupi et al. revealed that 12 months of therapy with OCs failed to improve the HRQoL in women with recurrent pelvic pain (n = 43), with the symptoms relapsing after discontinuation [22].”

    From Health-related quality of life in women with endometriosis: a systematic review (2012) · cites this paper as [22]

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2 retracted

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Research works printed but not linked: 4

  1. American College of Obstetricians and Gynecologists. Clinical manage- ment guidelines for obstetrician-gynecologists. Medical management of endometriosis. ACOG Practice Bulletin number 11. Washington, DC: American College of Obstetricians and Gynecologists, 1999.
  2. Martinez-Madrid B, Dolmans MM, Van Langendonckt A, Defrere S, Donnez J. Freeze-thawing intact human ovary with its vascular pedicle with a passive cooling device. Fertil Steril 2004;82:1390 -4.
  3. Bedaiwy A, Jeremias E, Gurunluoglu R, Hussein MR, Siemianow M, Biscotti C, et al. Restoration of ovarian function after autotransplantation of intact frozen-thawed sheep ovaries with microvascular anastomosis. Fertil Steril 2003;79:594 -602.
  4. Revel A, Elami A, Bor A, Yavin S, Natan Y, Arav A. Whole sheep ovary cryopreservation and transplantation. Fertil Steril 2004;82:1714 -5. doi:10.1016/j.fertnstert.2005.01.006 Erratum In the November 2004 issue of Fertility and Sterility (vol. 82, no. 5) on page 1303, Dr. Caterina Exacoustos' name was misspelled. Please note that this was not an editorial error. · DOI

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Authors
Zupi, E., Marconi, D., Sbracia, M., Zullo, F., De Vivo, B., Exacustos, C., & Sorrenti, G.
Affiliations
  • University of Rome Tor Vergata (IT)
  • Magna Graecia University (IT)
  • Policlinico Tor Vergata (IT)
Corresponding author
Sbracia, Marco
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2004-11
Volume
82
Issue
5
Pages
1303-1308
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2004.03.062
OpenAlex
W2082587924
Cited by
103
References
29
Citations by year
2026: 4 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 2 · 2021: 5 · 2020: 6 · 2019: 4 · 2018: 3 · 2017: 6 · 2016: 3 · 2015: 5 · 2014: 9 · 2013: 3 · 2012: 7
FWCI
4.55
Type
journal article
Language
en
Update notices
erratum (2005-04-01)
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
  • Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
Keywords
endometriosis, add-back therapy, GnRH analogues, estroprogestins, oral contraceptives, endometriosis-associated pain, pelvic pain, dysmenorrhea, dyspareunia, quality of life, bone mineral loss, endometriosis recurrence, endometriosis surgery
MeSH terms
Adult, Contraceptives, Oral, Drug Administration Schedule, Drug Combinations, Drug Therapy, Combination, Dysmenorrhea, Dyspareunia, Endometriosis, Ethinyl Estradiol, Female, Humans, Gonadotropin-Releasing Hormone, Norpregnenes, Pain Measurement, Palliative Care, Quality of Life, Surveys and Questionnaires, Recurrence, Bone Density, Pelvic Pain

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