Continuous use of an oral contraceptive for endometriosis-associated recurrent dysmenorrhea that does not respond to a cyclic pill regimen
Continuous use of an oral contraceptive for endometriosis-associated recurrent dysmenorrhea that does not respond to a cyclic pill regimen
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DOI：
10.1016/s0015-0282(03)00794-5
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发表时间：
2003-09-01
影响因子：
6.7
通讯作者：
Crosignani, PG
中科院分区：
文献类型：
--
作者：
Vercellini, P;Frontino, G;Crosignani, PG
目的：为了确定是否长期减少疼痛是通过持续给药口服避孕药（OC）的妇女子宫内膜异位症相关的复发性痛经，不响应周期OC的使用。设计：前瞻性，治疗性，自我对照临床试验。设置：三级保健和转诊中心的子宫内膜异位症患者。患者（s）：在前一年接受子宫内膜异位症手术的50名女性，尽管使用了周期性OC，但仍出现了复发性痛经。持续使用含炔雌醇的OC（0.02 mg）和去氧孕烯（0.15毫克）2年。主要结果测量：使用100 mm视觉模拟量表和0- 3分口头评分量表评估周期性和连续OC使用期间的痛经变化，以及对连续OC治疗的满意度。在研究期间，19名（38%）、18名（36%）和13名（26%）女性报告了经闭、点状出血和突破性出血。>7天出血事件以及随后的7天OC暂停的平均+/- SD数量为5.5 +/- 2.1。平均+/- SD痛经视觉模拟量表和语言评定量表评分在基线时分别为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%）例女性报告了中度或重度副作用。在最后的评估，13（26%）妇女非常满意，27（54%）满意，1（2%）是不确定的，8（16%）不满意，1（2%）是非常dissatisfactory. Conclusions（S）：长期连续OC使用可以提出妇女有症状的子宫内膜异位症和子宫内膜异位症相关的疼痛症状。(C)2003年，美国生殖医学会。
Objective: 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.Design: Prospective, therapeutic, self-controlled clinical trial.Setting: 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. (C) 2003 by American Society for Reproductive Medicine.