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Long-term oral contraceptive pills and postoperative pain management after laparoscopic excision of ovarian endometrioma: a randomized controlled trial
Open accessAbstract
Objective To evaluate postoperative long-term cyclic and continuous administration of combined oral contraceptive (OC) pills in preventing endometriosis-related pain recurrence.Design Prospective, randomized, controlled trial.Setting Tertiary care university hospital.Patient(s) Three hundred eleven women who underwent laparoscopic excision for symptomatic ovarian endometrioma.Intervention(s) Patients were randomly divided into three groups: nonuser group receiving no therapy, and cyclic user group and continuous user group receiving low-dose, monophasic OC pills for 24 months in either cyclic or continuous administration.Main outcome measure(s) Presence and intensity of dysmenorrhea, dyspareunia, and chronic pelvic pain were assessed by a 10-point visual analogue scale (VAS) at 6, 12, 18, and 24 months postoperatively.Result(s) A significant reduction in recurrence rate and VAS scores for dysmenorrhea was evident in the continuous users versus the other groups at 6 months, and in cyclic users versus nonusers at 18 months postoperatively. No significant differences in recurrence rate and VAS scores for dyspareunia and chronic pelvic pain were demonstrated among the groups. The increase of VAS scores from 6-24 months during the study period for dysmenorrhea, dyspareunia, and chronic pelvic pain was significantly higher in nonusers than in the other groups.Conclusion(s) Long-term postoperative use of OC pills can reduce the frequency and the severity of recurrent endometriosis-related dysmenorrhea.
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“Some studies showed that COCs prevent and reduce frequency and severity of recurrent dysmenorrhea and relapse of endometriosis after surgery [252–256].”
From Hormonal treatments for endometriosis: The endocrine background (2022) · cites this paper as [253]
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“The continuous use of COCs after conservative surgery is more beneficial than the cyclic use [253, 256, 257].”
From Hormonal treatments for endometriosis: The endocrine background (2022) · cites this paper as [253]
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Citations
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“Because dysmenorrhea seems related to recurrent microbleeding within the endometriotic implants and the associated inflammation (1), OC pills can be effective by inducing atrophy of the endometrial tissue (9), reducing cell proliferation, and increasing apoptosis in the endometrium (18).”
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Metadata
- Authors
- Seracchioli, R., Mabrouk, M., Frascà, C., Manuzzi, L., Savelli, L., & Venturoli, S.
- Affiliations
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- Corresponding author
- Seracchioli, Renato
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 94
- Issue
- 2
- Pages
- 464-471
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2039313615
- Cited by
- 158
- References
- 20
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 7 · 2023: 1 · 2022: 4 · 2021: 9 · 2020: 15 · 2019: 7 · 2018: 9 · 2017: 13 · 2016: 8 · 2015: 22 · 2014: 10 · 2013: 14 · 2012: 11
- FWCI
- 13.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (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 › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- oral contraceptives, combined oral contraceptives, endometrioma, endometriosis recurrence, postoperative pain management, laparoscopic resection, dysmenorrhea, dyspareunia, chronic pelvic pain
- MeSH terms
- Adult, Chronic Disease, Contraceptives, Oral, Dysmenorrhea, Dyspareunia, Endometriosis, Female, Humans, Ovarian Diseases, Postoperative Pain, Laparoscopy, Time Factors, Treatment Outcome, Disease-Free Survival, Kaplan-Meier Estimate, Secondary Prevention, Young Adult
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