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Fertil Steril. 2013 Nov;100(5):1337-42. doi: 10.1016/j.fertnstert.2013.07.008. Epub 2013 Aug 13.

Continuous versus cyclic use of oral contraceptives after surgery for symptomatic endometriosis: a prospective cohort study.

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  • 12nd Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Athens, Greece.

Abstract

OBJECTIVE:

To evaluate the efficacy of continuous oral contraceptive (OC) use versus the usual cyclic fashion in the recurrence of endometriosis-related symptoms after surgery.

DESIGN:

Prospective cohort trial involving patients in two tertiary care units.

SETTING:

Academic institution in collaboration with a private hospital.

PATIENT(S):

356 patients underwent surgical treatment by laparoscopy for symptomatic endometriosis.

INTERVENTION(S):

After surgical treatment for endometriosis, patients offered 6-month course of cyclic OC (including a 7-day pill-free period) or continuous OC.

MAIN OUTCOME MEASURE(S):

Recurrence rate of endometriosis-related symptoms and endometriomas after fertility-sparing surgery.

RESULT(S):

Out of 356 patients, 167 were placed on the usual cyclic OC course and 85 on continuous OC for a minimum of 6 months. The continuous OC group experienced a statistically significant reduction in recurrence rates for endometrioma, dysmenorrhea, and non-menstrual pelvic pain as compared with the cyclic OC group. There was no reduction in the recurrence of dyspareunia between the two groups.

CONCLUSION(S):

After surgical treatment of endometriosis, the use of both cyclic and continuous OC improves pain symptoms when compared with preoperative scores. Continuous OC appears to be associated with a reduced recurrence rate for dysmenorrhea, non-menstrual pelvic pain, and endometrioma but not for dyspareunia as compared with cyclic OC.

Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Drosperinone; dysmenorrhea; endometriosis; laparoscopy; non-menstrual pelvic pain; oral contraceptives

PMID:
23953327
[PubMed - indexed for MEDLINE]
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