CoChat
Sign Up
Cited by 363Endometriosis Research and TreatmentMenstrual Health and DisordersEctopic Pregnancy Diagnosis and Management

Randomized clinical trial of a levonorgestrel-releasing intrauterine system and a depot GnRH analogue for the treatment of chronic pelvic pain in women with endometriosis

Petta, Carlos A., Ferriani, Rui A., Abrao, Mauricio S., Hassan, Daniela, Rosa e Silva, Julio C., Podgaec, Sergio, Bahamondes, Luis·2005·Human Reproduction
DOI 10.1093/humrep/deh869
Open this paper in CoChat — free account

Abstract

BACKGROUND: The objective of this multicentre randomized, controlled clinical trial was to compare the efficacy of a levonorgestrel-releasing intrauterine system (LNG-IUS) and a depot-GnRH-analogue in the control of endometriosis-related pain over a period of six months. METHODS: Eighty-two women, 18 to 40 years of age (mean 30 years), with endometriosis, dysmenorrhoea and/or CPP, were randomized using a computer-generated system of sealed envelopes into either LNG-IUS (n = 39) or GnRH analogue (n = 43) treatment groups at three university centres. Daily scores of endometriosis-associated CPP were evaluated using the Visual Analogue Scale (VAS), daily bleeding score was calculated from bleeding calendars, and improvement in quality of life was evaluated using the Psychological General Well-Being Index Questionnaire (PGWBI). The pain score diary was based on the VAS in which women recorded the occurrence and intensity of pain on a daily basis. A monthly score was calculated from the result of the sum of the daily scores divided by the number of days in each observation period. RESULTS: CPP decreased significantly from the first month throughout the six months of therapy with both forms of treatment and there was no difference between the groups (P > 0.999). In both treatment groups, women with stage III and IV endometriosis showed a more rapid improvement in the VAS pain score than women with stage I and II of the disease (P < 0.002). LNG-IUS users had a higher bleeding score than GnRH-analogue users at all time points of observation with 34% and 71% of patients in the LNG-IUS and GnRH-analogue groups, respectively, reporting no bleeding during the first treatment month, and 70% and 98% reporting no bleeding during the sixth month. No difference was observed between groups with reference to improvement in quality of life. CONCLUSIONS: Both, the LNG-IUS and the GnRH-analogue were effective in the treatment of CPP-associated endometriosis, although no differences were observed between the two treatments. Among the additional advantages of the LNG-IUS is the fact that it does not provoke hypoestrogenism and that it requires only one medical intervention for its introduction every 5 years. This device could therefore become the treatment of choice for CPP-associated endometriosis in women who do not wish to conceive.

Integrity signals

Registry

Crossref · 10.1093/humrep/deh869

Cites

34 of 34 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In that trial, 13% (n=5) of LNG-IUS patients and 14% (n=6) of GnRHa patients failed to reach a VAS pain score of less than three.

    “At the end of the study, the 13% ( n = 5) of patients in the LNG-IUS group and the 14% ( n = 6) in the GnRHa group failed to reach a VAS pain score of less than three.”

    From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [80]

  • In both treatment groups of that trial, patients with stage III and IV disease achieved the more rapid improvement in VAS score.

    “In both treatment groups, the subgroup of patients that achieved the more rapid improvement in VAS score was the one of patients with stage III and IV of the disease.”

    From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [80]

  • In a Brazilian multicenter trial of 82 women with symptomatic endometriosis, LNG-IUS and depot GnRHa were similarly effective at 6 months for endometriosis-related chronic pelvic pain, with a six-point decrease from baseline in VAS pain score in both groups.

    “In particular, a Brazilian multicenter trial [80] compared the efficacy of the LNG-IUS and a depot GnRHa in 82 women with symptomatic endometriosis. At 6-months follow-up both treatments appeared to be similarly effective for endometriosis-related chronic pelvic pain, with a six-points decrease from baseline in VAS pain score in both study groups.”

    From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [80]

  • Progestins are positively associated with health-related quality of life in women with endometriosis.

    “Progestins were positively associated with HRQoL in women with endometriosis [20,21,23-25,27,29,30].”

    From Health-related quality of life in women with endometriosis: a systematic review (2012) · cites this paper as [23]

  • Six months of progestin therapy is equivalent to GnRHa in improving health-related quality of life and reducing pain in women with endometriosis.

    “Moreover, six months of therapy with progestins seemed equivalent to that of GnRHa in improving HRQoL and reducing pain, according to six RCTs [20,23-25,27,29].”

    From Health-related quality of life in women with endometriosis: a systematic review (2012) · cites this paper as [23]

Cites

1 retracted

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Petta, C. A., Ferriani, R. A., Abrao, M. S., Hassan, D., Rosa e Silva, J. C., Podgaec, S., & Bahamondes, L.
Affiliations
Universidade Estadual de Campinas (UNICAMP) (BR)
Corresponding author
Petta, Carlos A.
ORCID
Venue
Human Reproduction
Publisher
Oxford University Press (OUP)
Published
2005-03-24
Volume
20
Issue
7
Pages
1993-1998
ISSN
  • 0268-1161 (ISSN-L)
  • 1460-2350
DOI
10.1093/humrep/deh869
OpenAlex
W2123134517
Cited by
363
References
34
Citations by year
2026: 6 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 22 · 2021: 16 · 2020: 12 · 2019: 12 · 2018: 18 · 2017: 16 · 2016: 19 · 2015: 22 · 2014: 20 · 2013: 17 · 2012: 19
FWCI
25.58
Type
journal article
Language
en
Open access
closed
Locations
  • Human Reproduction (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, chronic pelvic pain, levonorgestrel-releasing intrauterine system, dysmenorrhea, endometriosis-associated pain, hemorrhage, quality of life, endometriosis stage, estrogen deficiency, treatment efficacy comparison, psychological well-being
MeSH terms
Adolescent, Adult, Delayed-Action Preparations, Endometriosis, Female, Humans, Intrauterine Devices, Medicated, Gonadotropin-Releasing Hormone, Leuprolide, Levonorgestrel, Pelvic Pain

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review