Vercellini Paolo, Frontino Giada, De Giorgi Olga, Pietropaolo Giuliana, Pasin Roberta, Crosignani Pier Giorgio
Clinica Ostetrica e Ginecologica I, Istituto Luigi Mangiagalli, University of Milano, Milan, Italy.
Fertil Steril. 2003 Sep;80(3):560-3. doi: 10.1016/s0015-0282(03)00794-5.
To ascertain whether long-term reduction of pain is obtained by continuous administration of an oral contraceptive (OC) in women with endometriosis-associated recurrent dysmenorrhea that does not respond to cyclic OC use.
Prospective, therapeutic, self-controlled clinical trial.
A tertiary care and referral center for patients with endometriosis.
PATIENT(S): Fifty women who underwent surgery for endometriosis in the previous year and experienced recurrent dysmenorrhea despite cyclic OC use.
INTERVENTION(S): Continuous use of an OC containing ethinyl estradiol (0.02 mg) and desogestrel (0.15 mg) for 2 years.
MAIN OUTCOME MEASURE(S): Dysmenorrhea variation during cyclic and continuous OC use, evaluated with a 100-mm visual analog scale and a 0- to 3-point verbal rating scale, and degree of satisfaction with continuous OC treatment.
RESULT(S): In the study period, amenorrhea, spotting, and breakthrough bleeding were reported by 19 (38%), 18 (36%), and 13 (26%) women. The mean +/- SD number of >7-day bleeding episodes with consequent 7-day OC suspension was 5.5 +/- 2.1. The mean +/- SD dysmenorrhea visual analog scale and verbal rating scale scores were 75 +/- 13 and 2.4 +/- 0.5 at baseline and 31 +/- 17 and 0.7 +/- 0.6 at 2-year follow-up, respectively. Moderate or severe side effects were reported by 7/50 (14%) women. At final evaluation, 13 (26%) women were very satisfied, 27 (54%) were satisfied, 1 (2%) was uncertain, 8 (16%) were dissatisfied, and 1 (2%) was very dissatisfied.
CONCLUSION(S): Long-term continuous OC use can be proposed to women with symptomatic endometriosis and menstruation-related pain symptoms.
确定对于患有子宫内膜异位症相关复发性痛经且对周期性口服避孕药（OC）治疗无效的女性，持续服用OC是否能长期减轻疼痛。
前瞻性、治疗性、自身对照临床试验。
一家子宫内膜异位症患者的三级护理和转诊中心。
50名女性，她们在上一年接受了子宫内膜异位症手术，尽管使用了周期性OC，但仍有复发性痛经。
持续使用含有炔雌醇（0.02mg）和去氧孕烯（0.15mg）的OC两年。
在周期性和持续使用OC期间痛经的变化，采用100mm视觉模拟量表和0至3分的语言评定量表进行评估，以及对持续OC治疗的满意度。
在研究期间，19名（38%）女性报告有闭经、点滴出血和突破性出血，18名（36%）女性报告有点滴出血，13名（26%）女性报告有突破性出血。因出血持续>7天而导致OC停药7天的平均次数±标准差为5.5±2.1。痛经视觉模拟量表和语言评定量表的平均±标准差得分在基线时分别为75±13和2.4±0.5，在2年随访时分别为31±17和0.7±0.6。7/50（14%）女性报告有中度或重度副作用。在最终评估中，13名（26%）女性非常满意，27名（54%）女性满意，1名（2%）女性不确定，8名（16%）女性不满意，1名（2%）女性非常不满意。
对于有症状的子宫内膜异位症和与月经相关疼痛症状的女性，可以建议长期持续使用OC。
