Treatment of symptomatic rectovaginal endometriosis with an estrogen-progestogen combination versus low-dose norethindrone acetate

Paolo Vercellini, Giuliana Pietropaolo, Olga De Giorgi, Roberta Pasin, Annalisa Chiodini, Pier Giorgio Crosignani

Research output: Contribution to journalArticle

144 Citations (Scopus)

Abstract

Objective: To evaluate the efficacy, safety, and tolerability of an estrogen-progestogen combination versus low-dose norethindrone acetate in the treatment of persistent pain after surgery for symptomatic rectovaginal endometriosis. Design: Randomized controlled trial. Setting: Academic center. Patient(s): Ninety women with recurrent moderate or severe pelvic pain after unsuccessful conservative surgery for symptomatic rectovaginal endometriosis. Intervention(s): Twelve-month, continuous treatment with oral ethinyl E 2, 0.01 mg, plus cyproterone acetate, 3 mg/day, or norethindrone acetate, 2.5 mg/day. Main Outcome Measure(s): Degree of satisfaction with therapy. Result(s): Seven women in the ethinyl E2 plus cyproterone acetate arm and five in the norethindrone acetate arm withdrew because of side effects (n=5), treatment inefficacy (n=6), or loss to follow-up (n=1). At 12 months, dysmenorrhea, deep dyspareunia, nonmenstrual pelvic pain, and dyschezia scores were substantially reduced without major between-group differences. Both regimens induced minor unfavorable variations in the serum lipid profile. According to an intention-to-treat analysis, 28 (62%) out of 45 patients in the ethinyl E2 plus cyproterone acetate group and 33 (73%) out of 45 in the norethindrone acetate group were satisfied with the treatment received. Conclusion(s): Low-dose norethindrone acetate could be considered an effective, tolerable, and inexpensive first-choice medical alternative to repeat surgery for treating symptomatic rectovaginal endometriotic lesions in patients who do not seek conception.

Original languageEnglish
Pages (from-to)1375-1387
Number of pages13
JournalFertility and Sterility
Volume84
Issue number5
DOIs
Publication statusPublished - Nov 2005

Fingerprint

Progestins
Endometriosis
Estrogens
Cyproterone Acetate
Pelvic Pain
Dyspareunia
Therapeutics
Dysmenorrhea
Intention to Treat Analysis
Constipation
Reoperation
Randomized Controlled Trials
Outcome Assessment (Health Care)
norethindrone acetate
Lipids
Safety
Pain
Serum

Keywords

  • Dysmenorrhea
  • Dyspareunia
  • Endometriosis
  • Estrogen-progestogen combination
  • Medical treatment
  • Pelvic pain
  • Progestogen

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Treatment of symptomatic rectovaginal endometriosis with an estrogen-progestogen combination versus low-dose norethindrone acetate. / Vercellini, Paolo; Pietropaolo, Giuliana; De Giorgi, Olga; Pasin, Roberta; Chiodini, Annalisa; Crosignani, Pier Giorgio.

In: Fertility and Sterility, Vol. 84, No. 5, 11.2005, p. 1375-1387.

Research output: Contribution to journalArticle

Vercellini, Paolo ; Pietropaolo, Giuliana ; De Giorgi, Olga ; Pasin, Roberta ; Chiodini, Annalisa ; Crosignani, Pier Giorgio. / Treatment of symptomatic rectovaginal endometriosis with an estrogen-progestogen combination versus low-dose norethindrone acetate. In: Fertility and Sterility. 2005 ; Vol. 84, No. 5. pp. 1375-1387.
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AU - Vercellini, Paolo

AU - Pietropaolo, Giuliana

AU - De Giorgi, Olga

AU - Pasin, Roberta

AU - Chiodini, Annalisa

AU - Crosignani, Pier Giorgio

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