Continuous Oral Contraceptives More Effective After Endometriosis Surgery
Review shows reduced recurrence rates for dysmenorrhea with continuous versus cyclic schedule.
HealthDay News -- For patients after surgery for endometriosis, a continuous oral contraceptive schedule seems better than a cyclic schedule, according to a review published in the American Journal of Obstetrics & Gynecology.
Ludovico Muzii, MD, from the Sapienza University of Rome, and colleagues conducted a systematic review and meta-analysis to compare a continuous versus a cyclic oral contraceptive schedule after surgical excision of ovarian endometriomas. Data were included from 3 randomized clinical trials and 1 prospective controlled study, with 557 patients with endometriosis, of whom 343 had ovarian endometriomas and completed the assigned treatment and follow-up.
The researchers found that a continuous schedule correlated with lower recurrence rates for dysmenorrhea (risk ratio, 0.24; 95% confidence interval, 0.06 to 0.91; P = 0.04).
There were nonsignificant between-group differences for chronic pelvic pain and dyspareunia.
Compared with a cyclic schedule, a continuous oral contraceptive schedule correlated with a nonsignificant reduction of cyst recurrence rates (risk ratio, 0.54; 95% confidence interval, 0.28 to 1.05; P = 0.07).
"Due to the small number and small sample sizes of the included studies, further randomized clinical trials are needed to confirm the findings of the present systematic review," the authors write. "Also, outcomes related to patient satisfaction and quality of life should be addressed."
Muzii L, Di Tucci C, Achilli C et al. Continuous versus cyclic oral contraceptives after laparoscopic excision of ovarian endometriomas: a systematic review and metaanalysis. Am J Obstet Gynecol. 2016;214(2):203-211. doi:10.1016/j.ajog.2015.08.074.