The time of enrollment was from October 2017 to March 2019. Informed written consent was obtained from each woman before entering the study, and they did not receive payment of any kind. The study protocol conformed to the ethical guidelines of the 1975 Helsinki Declaration. The departmental institutional review board approved the study. Moreover, the quality of life (QoL) and sexual function were investigated (the secondary end points). This study aimed to evaluate the effects of an E2/NOMAC contraceptive pill on the pain symptoms of women affected by endometriosis-associated chronic pelvic pain without the desire for procreation (the primary end point). 17 NOMAC has a long half-life (45–50 hours) compared with other contraceptive progestins, and thus, it is able to cover the 4-day hormone-free interval by its steroidal effects consequently, its contraceptive efficacy could be more compared with progestins with a shorter half-life. Recently, a new oral CHC containing 1.5 mg 17β-estradiol (E2) with 2.5 mg nomegestrol acetate (NOMAC) has been used with 24 days of active pill use followed by a 4-day hormone-free interval regimen. 15 In fact, women on conventional CHCs may still experience headaches, pelvic pain, and mood changes during the hormone-free interval, mainly due to the raised estradiol levels and increased number of follicles induced by the increasing follicle-stimulating hormone levels during the hormone-free interval. 13, 14 Conventional 21/7 regimens can fail during the 7-day hormone-free interval producing limited benefits on pain symptoms therefore, continuous or extended CHC regimens were introduced. Outcomes depend on the specific dose, formulation, delivery system, or regimen. In fact, women without the desire for procreation are more likely to use CHCs. However, the first step in prescribing a drug for chronic pelvic pain is to understand the needs of each subject. 12 Women commonly adopt hormonal treatment when their doctor informs them that they are infertile and/or affected by endometriosis. It is customary for women affected by chronic pelvic pain to take on-demand nonsteroidal anti-inflammatory drugs (NSAIDs). In fact, when women discontinue their usage, pelvic pain usually reappears. Progestins taken orally 5–7 or by subdermal implant, 8 intrauterine device 9, 10 administration, or estrogen–progestin combined hormonal contraceptives (CHCs) 3 are normally used to counteract, but not to cure, chronic pelvic pain symptoms due to the effects of ovarian estrogenic secretion on the endometrium-like tissue developing outside the uterus. 1 Women frequently experience dysmenorrhea, dyspareunia, dyschezia, fatigue, and infertility together with chronic pelvic pain. The improvement of the pain symptoms, QoL, FSFI, and FSDS, was more evident in women on E2/NOMAC than in those on NSAIDs, when the study group and control group values were compared at the 3- and 6-month follow-ups ( p < 0.001).Ĭonclusions: Women on E2/NOMAC COC showed a better reduction of endometriosis-associated chronic pelvic pain and an improvement of their QoL and sexual activity than those of the women on NSAIDs.Īpproximately 10 % of women of reproductive age are affected by endometriosis-associated chronic pelvic pain. However, they had a limited improvement of their FSFI and FSDS ( p < 0.001). Women on NSAIDs did not report any reduction in pain symptoms or improvement in QoL ( p ≤ 0.4). SF-36, FSFI, and FSDS had a similar trend at the 3- and 6-month follow-ups ( p < 0.001). Results: Improvement in chronic pelvic pain was observed in the study group at both the 3- and 6-month follow-ups ( p < 0.001). The study included two follow-ups at 3 and 6 months. To assess their QoL, sexual function, and sexual distress, the Short Form-36 (SF-36), the Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale (FSDS) were used, respectively. The visual analogic scale was used to measure the levels of pelvic pain, dysmenorrhea, and dyspareunia. Materials and Methods: Ninety-nine women on E2/NOMAC constituted the study group and 63 women on NSAIDs constituted the control group. Background: To evaluate the effects of a 24/4 regimen combined oral contraceptive (COC) containing 1.5 mg 17β-estradiol (E2) and 2.5 mg nomegestrol acetate (NOMAC) compared to on-demand nonsteroidal anti-inflammatory drugs (NSAIDs) on women affected by endometriosis-associated chronic pelvic pain (the primary end point) and their quality of life (QoL) and sexual function (the secondary end points).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |