A gonadotropin-releasing hormone agonist versus a low-dose oral contraceptive for pelvic pain associated with endometriosis
Open accessAbstract
Objectives To evaluate the efficacy of goserelin versus a low-dose cyclic oral contraceptive (OC) in improving pelvic pain in women with endometriosis and to compare recurrence of symptoms during follow-up.Design Open-label, randomized trial.Setting University hospital endometriosis center.Patients Fifty-seven women with moderate or severe pelvic pain and laparoscopically diagnosed endometriosis.Interventions Six-month treatment with goserelin depot (n = 29) or a low-dose cyclic OC (n = 28) followed by 6-month follow-up.Main outcome measures Variation in severity of symptoms during treatment and at the end of follow-up as shown by a linear analog scale and a verbal rating scale.Results At 6 months of treatment, a significant reduction in deep dyspareunia was observed in both groups, with goserelin superior to the OC at linear analog scale assessment. Nonmenstrual pain was diminished on both scales without differences between treatments. Women taking the OC experienced a significant reduction in dysmenorrhea. At the end of follow-up, symptoms reappeared without differences in severity between the groups.Conclusions Low-dose cyclic OCs may be a valuable alternative for the treatment of dysmenorrhea and nonmenstrual pain associated with endometriosis. Symptoms recurred in most subjects 6 months after drug withdrawal.
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The proportion of endometriosis patients satisfied with OC treatment is ≥65%.
“Based on our previous experience, the proportion of endometriosis patients satisfied with OC treatment is $65% (20,57).”
From A stepped-care approach to symptomatic endometriosis management: A participatory research initiative (2018) · cites this paper as [57]
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., 1993
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., 1993
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., 1993
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- Authors
- Vercellini, P., Trespidi, L., Colombo, A., Vendola, N., Marchini, M., & Crosignani, P. G.
- Affiliations
- University of Milan (IT)
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 1993-07
- Volume
- 60
- Issue
- 1
- Pages
- 75-79
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W252619442
- Cited by
- 311
- References
- 19
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 6 · 2023: 3 · 2022: 6 · 2021: 7 · 2020: 7 · 2019: 6 · 2018: 16 · 2017: 6 · 2016: 11 · 2015: 9 · 2014: 17 · 2013: 11 · 2012: 18
- FWCI
- 3.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (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, goserelin, GnRH agonist, low-dose oral contraceptives, dysmenorrhea, deep dyspareunia, symptom recurrence, treatment efficacy
- MeSH terms
- Adolescent, Adult, Contraceptives, Oral, Dysmenorrhea, Dyspareunia, Endometriosis, Female, Follow-Up Studies, Humans, Pain, Recurrence, Goserelin
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