Shifting from Oral Contraceptives to Norethisterone Acetate, or Vice Versa, because of Drug Intolerance

Does the Change Benefit Women with Endometriosis?

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background/Aims: Oral contraceptives (OC) and norethisterone acetate (NETA) are among first-line medical therapies for symptomatic endometriosis, but their use is sometimes associated with intolerable side effects. We investigated whether shifting from low-dose OC to NETA (2.5 mg/day), or vice versa, improved tolerability. Methods: Sixty-seven women willing to discontinue their treatment because of intolerable side effects despite good pain relief, were enrolled in a self-controlled study, and shifted from OC to NETA (n = 35) or from NETA to OC (n = 32). The main study outcome was satisfaction with treatment 12 months after the change. Tolerability, pain symptoms, health-related quality of life, psychological status, and sexual functioning were also evaluated. Results: After treatment change, good tolerability was reported by 37% of participants who shifted to NETA, and by 52% of those who shifted to OC. At 12-month assessment, 51% of women intolerant to OC were satisfied with NETA, and 65% of those intolerant to NETA were satisfied with OC (intention-to-treat analysis). Other study variables did not vary substantially. Conclusions: In selected endometriosis patients, shifting from OC to NETA, or vice versa, because of side effects, improved tolerability. Better results were observed when substituting NETA with OC rather than the other way round.

Original languageEnglish
Pages (from-to)275-284
JournalGynecologic and Obstetric Investigation
Volume83
Issue number3
DOIs
Publication statusPublished - 2018

Fingerprint

Endometriosis
Oral Contraceptives
Pharmaceutical Preparations
norethindrone acetate
Pain
Intention to Treat Analysis
Therapeutics
Quality of Life
Outcome Assessment (Health Care)
Psychology

Keywords

  • Endometriosis
  • Estrogen-progestin combinations
  • Medical treatment
  • Norethisterone acetate
  • Pelvic pain
  • Progestins

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this

@article{67aa3e286d5543549aa7d1193c3b52b4,
title = "Shifting from Oral Contraceptives to Norethisterone Acetate, or Vice Versa, because of Drug Intolerance: Does the Change Benefit Women with Endometriosis?",
abstract = "Background/Aims: Oral contraceptives (OC) and norethisterone acetate (NETA) are among first-line medical therapies for symptomatic endometriosis, but their use is sometimes associated with intolerable side effects. We investigated whether shifting from low-dose OC to NETA (2.5 mg/day), or vice versa, improved tolerability. Methods: Sixty-seven women willing to discontinue their treatment because of intolerable side effects despite good pain relief, were enrolled in a self-controlled study, and shifted from OC to NETA (n = 35) or from NETA to OC (n = 32). The main study outcome was satisfaction with treatment 12 months after the change. Tolerability, pain symptoms, health-related quality of life, psychological status, and sexual functioning were also evaluated. Results: After treatment change, good tolerability was reported by 37{\%} of participants who shifted to NETA, and by 52{\%} of those who shifted to OC. At 12-month assessment, 51{\%} of women intolerant to OC were satisfied with NETA, and 65{\%} of those intolerant to NETA were satisfied with OC (intention-to-treat analysis). Other study variables did not vary substantially. Conclusions: In selected endometriosis patients, shifting from OC to NETA, or vice versa, because of side effects, improved tolerability. Better results were observed when substituting NETA with OC rather than the other way round.",
keywords = "Endometriosis, Estrogen-progestin combinations, Medical treatment, Norethisterone acetate, Pelvic pain, Progestins",
author = "Paolo Vercellini and Federica Ottolini and Frattaruolo, {Maria Pina} and Laura Buggio and Anna Roberto and Edgardo Somigliana",
year = "2018",
doi = "10.1159/000486335",
language = "English",
volume = "83",
pages = "275--284",
journal = "Gynecologic and Obstetric Investigation",
issn = "0378-7346",
publisher = "S. Karger AG",
number = "3",

}

TY - JOUR

T1 - Shifting from Oral Contraceptives to Norethisterone Acetate, or Vice Versa, because of Drug Intolerance

T2 - Does the Change Benefit Women with Endometriosis?

AU - Vercellini, Paolo

AU - Ottolini, Federica

AU - Frattaruolo, Maria Pina

AU - Buggio, Laura

AU - Roberto, Anna

AU - Somigliana, Edgardo

PY - 2018

Y1 - 2018

N2 - Background/Aims: Oral contraceptives (OC) and norethisterone acetate (NETA) are among first-line medical therapies for symptomatic endometriosis, but their use is sometimes associated with intolerable side effects. We investigated whether shifting from low-dose OC to NETA (2.5 mg/day), or vice versa, improved tolerability. Methods: Sixty-seven women willing to discontinue their treatment because of intolerable side effects despite good pain relief, were enrolled in a self-controlled study, and shifted from OC to NETA (n = 35) or from NETA to OC (n = 32). The main study outcome was satisfaction with treatment 12 months after the change. Tolerability, pain symptoms, health-related quality of life, psychological status, and sexual functioning were also evaluated. Results: After treatment change, good tolerability was reported by 37% of participants who shifted to NETA, and by 52% of those who shifted to OC. At 12-month assessment, 51% of women intolerant to OC were satisfied with NETA, and 65% of those intolerant to NETA were satisfied with OC (intention-to-treat analysis). Other study variables did not vary substantially. Conclusions: In selected endometriosis patients, shifting from OC to NETA, or vice versa, because of side effects, improved tolerability. Better results were observed when substituting NETA with OC rather than the other way round.

AB - Background/Aims: Oral contraceptives (OC) and norethisterone acetate (NETA) are among first-line medical therapies for symptomatic endometriosis, but their use is sometimes associated with intolerable side effects. We investigated whether shifting from low-dose OC to NETA (2.5 mg/day), or vice versa, improved tolerability. Methods: Sixty-seven women willing to discontinue their treatment because of intolerable side effects despite good pain relief, were enrolled in a self-controlled study, and shifted from OC to NETA (n = 35) or from NETA to OC (n = 32). The main study outcome was satisfaction with treatment 12 months after the change. Tolerability, pain symptoms, health-related quality of life, psychological status, and sexual functioning were also evaluated. Results: After treatment change, good tolerability was reported by 37% of participants who shifted to NETA, and by 52% of those who shifted to OC. At 12-month assessment, 51% of women intolerant to OC were satisfied with NETA, and 65% of those intolerant to NETA were satisfied with OC (intention-to-treat analysis). Other study variables did not vary substantially. Conclusions: In selected endometriosis patients, shifting from OC to NETA, or vice versa, because of side effects, improved tolerability. Better results were observed when substituting NETA with OC rather than the other way round.

KW - Endometriosis

KW - Estrogen-progestin combinations

KW - Medical treatment

KW - Norethisterone acetate

KW - Pelvic pain

KW - Progestins

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DO - 10.1159/000486335

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