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Continuous versus cyclic oral contraceptives for the treatment of endometriosis: a systematic review

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A Letter to the Editor to this article was published on 09 June 2015

A Letter to the Editor to this article was published on 04 June 2015

Abstract

Purpose

Recurrence of endometriosis after conservative surgery has been observed in 40–50 % of patients within the first 5 years. A variety of regimens such as combined oral contraceptives, GnRH agonists, danazol, and progestins have been used postoperatively to reduce recurrence rates. Oral contraceptives (oCP) have been used either in a cyclic or in a continuous (no pill-free interval) fashion. The purpose of this article was to summarize the existing evidence on the efficacy and patient compliance for the use of oCP in a continuous versus cyclic fashion following conservative surgery for endometriosis.

Methods

A systematic search of Medline identified four eligible studies. Studies were considered eligible, if they have evaluated oCP therapy, either in a cyclic or continuous regimen, after conservative surgery for endometriosis. Specifically, studies (1) reporting on women with endometriosis who were treated postoperatively with both continuous oCP and cyclic oCP, (2) written in English, (3) with minimum 6 months duration of medical treatment, and (4) with minimum 12 months duration of follow-up were considered eligible for our systematic review. Outcome measures of these eligible studies were tabulated and then analyzed cumulatively. A purely descriptive approach was adopted concerning all variables.

Results

Postoperative use of continuous oCP was associated with a reduction in the recurrence rate of dysmenorrhea, delay in the presentation of dysmenorrhea, reduction in nonspecific pelvic pain, and reduction in the recurrence rate for endometrioma.

Conclusions

Use of oCP in a continuous fashion following conservative surgery for endometriosis is more beneficial to cyclic use.

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, General Hospital of Veria, Veria, Greece

    Konstantinos A. Zorbas

  2. Society of Junior Doctors, Athens, Greece

    Konstantinos A. Zorbas & Konstantinos P. Economopoulos

  3. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 101 Merrimack street, Boston, MA, 02114, USA

    Konstantinos P. Economopoulos

  4. Second Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens School of Medicine, Athens, Greece

    Nikos F. Vlahos

Authors
  1. Konstantinos A. Zorbas
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  2. Konstantinos P. Economopoulos
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  3. Nikos F. Vlahos
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Corresponding author

Correspondence to Konstantinos P. Economopoulos.

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Zorbas, K.A., Economopoulos, K.P. & Vlahos, N.F. Continuous versus cyclic oral contraceptives for the treatment of endometriosis: a systematic review. Arch Gynecol Obstet 292, 37–43 (2015). https://doi.org/10.1007/s00404-015-3641-1

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  • DOI: https://doi.org/10.1007/s00404-015-3641-1

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