Progestins in the symptomatic management of endometriosis: a meta-analysis on their effectiveness and safety

BMC Womens Health. 2022 Dec 17;22(1):526. doi: 10.1186/s12905-022-02122-0.

Abstract

Background: Endometriosis is a complex chronic disease that affects approximately 10% of women of reproductive age worldwide and commonly presents with pelvic pain and infertility.

Method & outcome measures: A systematic review of the literature was carried out using the databases Pubmed, Scopus, Cochrane and ClinicalTrials.gov in women with a confirmed laparoscopic diagnosis of endometriosis receiving progestins to determine a reduction in pain symptoms and the occurrence of adverse effects.

Results: Eighteen studies were included in the meta-analysis. Progestins improved painful symptoms compared to placebo (SMD = -0.61, 95% CI (-0.77, -0.45), P < 0.00001) with no comparable differences between the type of progestin. After median study durations of 6-12 months, the median discontinuation rate due to adverse effects was 0.3% (range: 0 - 37.1%) with mild adverse effects reported.

Conclusion: The meta-analysis revealed that pain improvement significantly increased with the use of progestins with low adverse effects.

Systematic review registration: PROSPERO CRD42021285026.

Keywords: Adverse effects; Endometriosis; Pain relief; Progestins.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Endometriosis* / complications
  • Endometriosis* / diagnosis
  • Endometriosis* / drug therapy
  • Female
  • Humans
  • Laparoscopy*
  • Pelvic Pain / drug therapy
  • Pelvic Pain / etiology
  • Progestins / therapeutic use

Substances

  • Progestins