Depot medroxyprogesterone acetate versus an oral contraceptive combined with very-low-dose danazol for long-term treatment of pelvic pain associated with endometriosis
Abstract
Objective Our purpose was to evaluate the efficacy and safety of depot medroxyprogesterone acetate versus an oral contraceptive combined with very-low-dose danazol in the long-term treatment of pelvic pain in women with endometriosis.Study design Eighty patients with endometriosis and moderate or severe pelvic pain were randomized to treatment for 1 year with intramuscular depot medroxyprogesterone acetate 150 mg every 3 months or a cyclic monophasic oral contraceptive (ethinyl estradiol 0.02 mg, desogestrel 0.15 mg) combined with oral danazol 50 mg a day for 21 days of each 28-day cycle. The women were asked to grade the degree of their satisfaction at the end of therapy. Variations in severity of symptoms during treatment were determined by a 10 cm visual analog and a 0- to 3-point verbal rating scale.Results Twenty nine of 40 subjects (72.5%) in the depot medroxyprogesterone acetate group were satisfied after 1 year of therapy compared with 23 of 40 (57.5%) in the oral contraceptive plus danazol group (chi 2(1) = 1.37, p = 0.24, odds ratio 1.95, 95% confidence interval 0.76 to 4.97). A significant decrease was observed in all symptom scores in both study groups. At 1-year assessment dysmenorrhea was significantly greater in women allocated to oral contraceptive plus danazol.Conclusion Depot medroxyprogesterone acetate seems to be an effective, safe, and convenient low-cost treatment for pelvic pain associated with endometriosis. However, women should be carefully counseled regarding menstrual changes and the potential prolonged delay in the return of ovulation.
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In that RCT, 72.5% in DMPA group were satisfied or very satisfied vs 57.5% in COC plus danazol group.
“Overall, at the end of treatment, 72.5% of the women in the DMPA group were satisfied or very satisfied compared with 57.5% in the COC plus danazol group.”
From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [49]
In a RCT of 80 women with endometriosis, intramuscular DMPA (150 mg/3 months) and cyclic COC plus low-dose oral danazol (50 mg/d) both significantly decreased all symptom scores without significant between-group differences.
“A significant decrease was demonstrated in all symptoms scores in both study groups without significant between-group differences.”
From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [49]
Progestins and oral contraceptives are effective in relieving pain in symptomatic endometriosis.
“The results consistently confirmed that progestins and OCs are effective in relieving pain”
From “Waiting for Godot”: a commonsense approach to the medical treatment of endometriosis (2011) · cites this paper as Vercellini et al., 1996
Progestins and oral contraceptives are generally well-tolerated.
“generally well-tolerated”
From “Waiting for Godot”: a commonsense approach to the medical treatment of endometriosis (2011) · cites this paper as Vercellini et al., 1996
Progestins and oral contraceptives are not inferior to danazol, GnRH agonists and aromatase inhibitors for treating symptomatic endometriosis.
“and not inferior to danazol, GnRH agonists and aromatase inhibitors”
From “Waiting for Godot”: a commonsense approach to the medical treatment of endometriosis (2011) · cites this paper as Vercellini et al., 1996
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- Authors
- Vercellini, P., De Giorgi, O., Oldani, S., Cortesi, I., Panazza, S., & Crosignani, P. G.
- Affiliations
- University of Milan (IT)
- ORCID
- Vercellini, Paolo
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 1996-08
- Volume
- 175
- Issue
- 2
- Pages
- 396-401
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W2099208499
- Cited by
- 161
- References
- 26
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 6 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 1 · 2018: 10 · 2017: 7 · 2016: 8 · 2015: 7 · 2014: 8 · 2013: 4 · 2012: 5
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- endometriosis, pelvic pain, dysmenorrhea, depot medroxyprogesterone acetate, danazol, oral contraceptives, desogestrel, ethinyl estradiol, long-term hormonal therapy, treatment satisfaction
- MeSH terms
- Adolescent, Adult, Contraceptives, Oral, Danazol, Delayed-Action Preparations, Drug Therapy, Combination, Endometriosis, Female, Humans, Palliative Care, Time Factors, Medroxyprogesterone Acetate, Pelvic Pain
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