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Progesterone receptor modulators (PRMs) like mifepristone show moderate evidence for relieving endometriosis pain, but can cause amenorrhea and hot flashes. More research is needed for other PRMs.

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Area of Science:

  • Reproductive Medicine
  • Pharmacology
  • Gynecology

Background:

  • Endometriosis is a common gynecological condition characterized by endometrial tissue outside the uterus.
  • This estrogen-dependent condition primarily affects women during their reproductive years.
  • Progesterone receptor modulators (PRMs) are investigated for endometriosis treatment due to their antiproliferative effects.

Purpose of the Study:

  • To evaluate the efficacy and safety of PRMs for endometriosis pain relief.
  • To compare PRMs against placebo, other treatments, or no treatment.
  • To assess outcomes in women of reproductive age with endometriosis.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) published in any language.
  • Searched multiple electronic databases and trial registers up to November 2016.
  • Included 10 RCTs involving 960 women, focusing on pain and side effects.

Main Results:

  • Mifepristone demonstrated moderate-quality evidence for reducing dysmenorrhea and low-quality evidence for dyspareunia.
  • Common side effects of mifepristone included amenorrhea (nearly 90%) and hot flushes (24%).
  • Evidence for other PRMs (asoprisnil, ulipristal, gestrinone) was insufficient or inconclusive regarding safety and effectiveness.

Conclusions:

  • Mifepristone is effective for endometriosis-related dysmenorrhea and potentially dyspareunia, despite common side effects.
  • Dosage of mifepristone may influence effectiveness, with lower doses potentially being less effective.
  • Insufficient evidence exists to draw firm conclusions on the safety and efficacy of other progesterone receptor modulators for endometriosis.