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Continuous versus cyclic use of oral contraceptives after surgery for symptomatic endometriosis: a prospective cohort
Nikos Vlahos1, Athanasios Vlachos, Olga Triantafyllidou
12nd Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Athens, Greece.
Objective:
To evaluate the efficacy of continuous oral contraceptive (OC) use versus the usual cyclic fashion in the recurrence of endometriosis-related symptoms after surgery.
Design:
Prospective cohort trial involving patients in two tertiary care units.
Setting:
Academic institution in collaboration with a private hospital.
Patient(S):
356 patients underwent surgical treatment by laparoscopy for symptomatic endometriosis.
Intervention(S):
After surgical treatment for endometriosis, patients offered 6-month course of cyclic OC (including a 7-day pill-free period) or continuous OC.
Main Outcome Measure(S):
Recurrence rate of endometriosis-related symptoms and endometriomas after fertility-sparing surgery.
Result(S):
Out of 356 patients, 167 were placed on the usual cyclic OC course and 85 on continuous OC for a minimum of 6 months. The continuous OC group experienced a statistically significant reduction in recurrence rates for endometrioma, dysmenorrhea, and non-menstrual pelvic pain as compared with the cyclic OC group. There was no reduction in the recurrence of dyspareunia between the two groups.
Conclusion(S):
After surgical treatment of endometriosis, the use of both cyclic and continuous OC improves pain symptoms when compared with preoperative scores. Continuous OC appears to be associated with a reduced recurrence rate for dysmenorrhea, non-menstrual pelvic pain, and endometrioma but not for dyspareunia as compared with cyclic OC.
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