Norethindrone acetate versus extended-cycle oral contraceptive (Seasonique®) in the treatment of endometriosis symptoms: A prospective open-label comparative study

Eur J Obstet Gynecol Reprod Biol. 2018 Mar:222:89-94. doi: 10.1016/j.ejogrb.2018.01.022. Epub 2018 Feb 3.

Abstract

Introduction: This patient preference prospective study was designed to compare patients' satisfaction in women with endometriosis treated either by an extended-cycle oral contraception (OC) or by norethindrone acetate (NETA).

Methods: This patient preference prospective study included women of reproductive age with endometriosis. Patients were submitted to one of the following 12 months' treatments: Group A, continuous oral treatment with NETA (2.5 mg/day) and Group B, a 91-day extended-cycle OC (LNG/EE 150/30 mcg for 84 days and EE 10 mcg for 7 days). Patient satisfaction was the primary endpoint.

Results: There was no statistically significant difference in the rate of satisfied patients at 12-month follow up between the two study groups, 82.2% and 68.4% in Group A and Group B respectively (p = 0.143). At 6 and 12-months, there was a significant amelioration in the intensity of all pain in both groups. The median number of days of unscheduled bleeding during the first cycle was significantly higher in Group B compared to Group A.

Conclusion: Both NETA and extended-cycle OC are effective in treating pain symptoms related to endometriosis. Extended-cycle OC may cause more unscheduled bleeding, but the rate of satisfaction for those who completed the treatment was similar in the two groups.

Keywords: Endometriosis; Extended-cycle oral contraception; Hormonal contraception.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Contraceptives, Oral, Synthetic / adverse effects
  • Contraceptives, Oral, Synthetic / therapeutic use*
  • Drug Combinations
  • Endometriosis / drug therapy*
  • Endometriosis / physiopathology
  • Ethinyl Estradiol / adverse effects
  • Ethinyl Estradiol / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Intention to Treat Analysis
  • Intestinal Diseases / drug therapy*
  • Intestinal Diseases / physiopathology
  • Italy / epidemiology
  • Levonorgestrel / adverse effects
  • Levonorgestrel / therapeutic use
  • Metrorrhagia / epidemiology
  • Metrorrhagia / etiology
  • Metrorrhagia / prevention & control
  • Norethindrone / adverse effects
  • Norethindrone / analogs & derivatives*
  • Norethindrone / therapeutic use
  • Norethindrone Acetate
  • Ovarian Diseases / drug therapy*
  • Ovarian Diseases / physiopathology
  • Pain Measurement
  • Patient Dropouts
  • Patient Preference*
  • Pelvic Pain / epidemiology
  • Pelvic Pain / etiology
  • Pelvic Pain / prevention & control
  • Prospective Studies
  • Vaginal Diseases / drug therapy*
  • Vaginal Diseases / physiopathology

Substances

  • Contraceptives, Oral, Synthetic
  • Drug Combinations
  • Seasonique
  • Ethinyl Estradiol
  • Levonorgestrel
  • Norethindrone Acetate
  • Norethindrone