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E
valuation
of
endometriosis
-
associated
pain
and
influence
of
conventional
treatment
:
a
systematic
review
R
ev
A
ssoc
M
ed
B
ras
2015; 61(6):507-518
511
TABLE 3
(Cont.) Main results of 17 studies that evaluated the effect of drugs on pain scores.
Study
Sample
Medication
used
Number of patients
treated
Information regarding pain
(instrument used, types of
pain, etc.)
Main results and/or conclusion
Figueiredo
and
Nascimento
13
10 women
with
endometriosis
LNG-IUS
10
VAS (pelvic pain before and af-
ter insertion of the LNG-IUS with
6 months of monitoring)
Before insertion of the LNG-IUS, the average pain score was 8.9 and, after
insertion, there was a decrease over the year, reaching an average of 1.8 in 6
months. At the end of treatment, the average satisfaction score given by the
patients was 9.8. This study showed that LNG-IUS was effective in reducing
the pelvic pain associated with endometriosis.
Ferrero et al.
15
82 patients
with
recto-vaginal
endometriosis
Letrozole
Norethis-
terone
acetate
41 from the L group (letrozole, norethis-
terone acetate)
41 from the N group (isolated norethis-
terone acetate)
VAS (dysmenorrhea, deep dys-
pareunia assessed before, 3 and
6 months during treatment and
3, 6 and 12 months after com-
pletion of treatment)
Intensity of CPP and deep dyspareunia was significantly lower in the L group
compared with the N group. At the end of treatment 63.4% of patients in the
N group were more satisfied with the treatment compared to 56.1% in the L
group (p=0.49). Adverse effects were more frequent in the L group than in
the N group (p=0.02). The combined use of drugs was more effective in re-
ducing painful symptoms; however, letrozole caused a high incidence of side
effects, its cost is higher and it did not improve patient satisfaction or influ-
ence the recurrence of pain.
Walch et al.
17
41 women
with
endometriosis
Implanon
DMPA
21 – treated with implanon
20 – treated with DMPA
VAS (dysmenorrhea, non-men-
strual pelvic pain and dyspareu-
nia assessed before and after 3,
6, 9 and 12 months of treatment)
The level of patient satisfaction with treatment was similar in both groups
(57% implanon
versus
58% DMPA). During the period of 1 year of treatment,
there was an improvement in pain intensity for both treatments. After 6
months, the mean decrease in pain was 68% in the group treated with Impla-
non and 53% in the DMPA group, but this difference was not statistically sig-
nificant (p=0.36). The results showed that in relation to pain relief, the ther-
apeutic efficacy of Implanon was not lower than DMPA, that is, both were
effective in reducing the pain associated with endometriosis.
Indraccolo
et al.
18
4 patients
with
endometriosis
and CPP
N-palmitoy-
lethanol-
amide Poly-
datin
Palmitoylethanolamide and polydatin
for 90 days
Pilot study
VAS (CPP, deep dyspareunia, dy-
schezia, dysuria and dysmenor-
rhea) before and 1, 2 and 3
months after treatment
Preliminary results showed that the patients reported pain relief after one
month of treatment. The palmitoylethanolamide/polydatin combination was
effective in controlling CPP associated with endometriosis.
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