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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
513
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
Ferrero et al.
22
35 patients
with
recto-vaginal
endometriosis
Letrozole
Norethis-
terone acetate
Triptorelin
17 from the N group (letrozole, nore-
thisterone acetate)
18 from the T group (letrozole, triptorelin)
VAS and Multidimensional
Categorical Classification
Scale (dysmenorrhea,
non-menstrual pelvic pain and
deep dyspareunia assessed
before, and after 3 and 6
months of treatment)
64.7% of patients in the N group reported being satisfied or very satisfied
with the treatment compared with 22.2% from the T group.
77.8% of the T group patients reported adverse effects
versus
35.3% from the
N group.
44.4% of the T group patients stopped treatment due to adverse effects
ver-
sus
5.9% from the N group.
During treatment, the bone mineral density significantly decreased in the T
group but not the N group.
Pain intensity decreased significantly during treatment in both groups.
This study demonstrated the effectiveness of the aromatase inhibitor in the
treatment of pain associated with endometriosis.
Ferrero et al.
23
15 women
with
recto-vaginal
endometriosis
LNG-IUS
Danazol
Vaginal danazol applied for 6 months VAS and Multidimensional Cate-
gorical Classification Scale (symp-
toms evaluated: dysmenorrhea,
non-menstrual pelvic pain, deep
dyspareunia and dyschezia)
Intensity of the symptoms evalu-
ated in three different situations:
isolated use of LNG-IUS and af-
ter 3 and 6 months of treatment
with vaginal danazol
Intensity of the symptoms of pain significantly decreased after administra-
tion of danazol for 3 months and continued to decrease even after 6 months
of treatment.
80% of patients were satisfied with the treatment.
Minimal adverse effects of LNG-IUS and vaginal danazol treatment: sebor-
rhea, oily hair or acne (n=4), headache (n=3), weight gain > 3 kg (n=2) and
vaginal irritation (n=2).
Vaginal danazol reduced the severity of the painful symptoms related to en-
dometriosis that persisted after insertion of LNG-IUS.
Guzick et al.
24
47 women
with
endometriosis
and CPP
Leuprolide
Continuous
oral contra-
ceptives
(COC)
21 – leuprolide
26 – continuous oral contraceptives
Biberoglu & Behrman/B & B and
Numerical Scale measured be-
fore treatment, and after 4, 12,
24, 36 and 48 weeks of treatment
Both products were equally effective in treating the pelvic pain associated
with endometriosis.
Mabrouk
et al.
26
106 women
with
endometriosis
COCs
75 – use of COCs
31 – non users of COCs
VAS (dysmenorrhea, dyspareu-
nia, CPP and dyschezia)
The comparison of VAS scores between the two groups showed that during the
preoperative period, dysmenorrhea and dyspareunia symptoms had higher VAS
scores (p=0.02 and p=0.005, respectively) in the untreated group, with wors-
ening of the intensity of the pain. The data suggest that therapy with combined
oral contraceptive may have a role in limiting the progression of dysmenorrhea
and dyspareunia associated with endometriosis.
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