Vannuccini Silvia, Biagiotti Chiara, Esposto Maria Celeste, La Torre Francesco, Clemenza Sara, Orlandi Gretha, Capezzuoli Tommaso, Petraglia Felice
Obstetrics and Gynecology Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Careggi University Hospital, Florence, Italy.
Endo-Care, Center for Endometriosis, Florence, Italy.
Gynecol Endocrinol. 2022 May;38(5):398-402. doi: 10.1080/09513590.2022.2047172. Epub 2022 Mar 3.
To evaluate the different effects of a progestin-only contraceptive with desogestrel (DSG) vs combined oral contraceptives (COCs) for a first line long-term treatment of endometriosis-related pain among patients seeking hormonal contraception.
An observational retrospective cohort study was conducted in collaboration with a local outpatient clinic for endometriosis among a group of nulliparous young women ( = 216) with endometriosis-related pain and seeking contraception. The cohort was subdivided into a group ( = 73) treated as first line by DSG and another group ( = 75) treated by a COC. During the study, clinical symptoms, side effects and possible changes in OC type use were recorded.
No significant difference was found between the two groups in terms of clinical characteristics and pain scores before treatment. After 6 months both treatments were effective in reducing endometriosis-related pain, and those treated with DSG showed lower levels of dysmenorrhea, dyspareunia and nonmenstrual pelvic pain than COCs group ( < .01). After 12 months, in DSG Group some patients (15%) switched from DSG to a COC for breakthrough bleeding, whereas in COC Group 48% of patients switched to another type of COC for reduced efficacy on pain and/or for side effects. After 3 years of OC treatment, in DSG Group 79% of patients maintained the same therapy, whereas in COC Group only 14% continued the same COC type, 37% switched to another COC and 47% to DSG.
A progestin-only contraceptive with DSG is a valid option for long term management of endometriosis-related pain in patients seeking hormonal contraception.
评估仅含去氧孕烯（DSG）的孕激素避孕药与复方口服避孕药（COC）对寻求激素避孕的子宫内膜异位症相关疼痛患者进行一线长期治疗的不同效果。
与当地一家子宫内膜异位症门诊合作，对一组未生育的年轻女性（n = 216）进行观察性回顾性队列研究，这些女性患有子宫内膜异位症相关疼痛且寻求避孕。该队列被分为一组（n = 73）接受DSG一线治疗，另一组（n = 75）接受COC治疗。在研究期间，记录临床症状、副作用以及OC类型使用的可能变化。
两组在治疗前的临床特征和疼痛评分方面无显著差异。6个月后，两种治疗方法均能有效减轻子宫内膜异位症相关疼痛，且接受DSG治疗的患者痛经、性交痛和非经期盆腔疼痛水平低于COC组（P < 0.01）。12个月后，DSG组一些患者（15%）因突破性出血从DSG改用COC，而COC组48%的患者因疼痛疗效降低和/或出现副作用而改用另一种类型的COC。OC治疗3年后，DSG组79%的患者维持相同治疗，而COC组只有14%的患者继续使用相同类型的COC，37%的患者改用另一种COC，47%的患者改用DSG。
仅含DSG的孕激素避孕药是寻求激素避孕的子宫内膜异位症相关疼痛患者长期管理的有效选择。
