Cochrane · systematic review · CD002122
Progestagens and anti‐progestagens for pain associated with endometriosis
Brown, J, Kives, S, Akhtar, M · Cochrane Database of Systematic Reviews · 2012 · Cochrane Library
Gynaecology and FertilityAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
26
current version
GRADE rated
26
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 9 · 34.6%Low 13 · 50%Moderate 4 · 15.4%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Progestagen compared to placebo for pain associated with endometriosis
Population: patients with pain associated with endometriosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
AFS score Progestagen vs placebo | no estimate extracted | 1 study · 33 participants | Low Downgraded: risk of bias |
Patient assessed efficacy, sum of all symptoms Progestagen vs placebo | no estimate extracted | 1 study · 33 participants | Low Downgraded: risk of bias |
Patient assessed efficacy, sum of all symptoms Progestagen vs placebo | no estimate extracted | 1 study · 29 participants | Low Downgraded: risk of bias |
Side effects ‐ acne Progestagen vs placebo | OR 9.6 [1, 91.96] | 1 study · 33 participants | Very low Downgraded: risk of bias |
Side effects ‐ oedema Progestagen vs placebo | OR 35.2 [3.6, 344.19] | 1 study · 33 participants | Very low Downgraded: risk of bias, imprecision |
Depot progestagen compared to other treatment for pain associated with endometriosis
Population: patients with pain associated with endometriosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Improvement in dysmenorrhoea Depot progestagen vs other treatment | OR 0.19 [0.05, 0.69] | 1 study · 274 participants | Low Downgraded: imprecision |
Improvement in dysmenorrhoea Depot progestagen vs other treatment | OR 0.63 [0.37, 1.08] | 1 study · 274 participants | Low |
Side effects ‐ hot flushes Depot progestagen vs other treatment | OR 0.3 [0.11, 0.83] | 2 studies · 354 participants | Low Downgraded: risk of bias |
Side effects ‐ amenorrhoea Depot progestagen vs other treatment | OR 21.18 [1.18, 380.9] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Side effects ‐ breakthrough bleeding/spotting Depot progestagen vs other treatment | OR 20.56 [6.44, 65.56] | 2 studies · 354 participants | Low Downgraded: risk of bias, imprecision |
Side effects ‐ bloating Depot progestagen vs other treatment | OR 4.39 [1.71, 11.3] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Side effects ‐ injection site reaction Depot progestagen vs other treatment | OR 20.64 [1.19, 358.23] | 1 study · 274 participants | Low Downgraded: imprecision |
Oral progestagens versus other treatment for pain associated with endometriosis
Population: patients with pain associated with endometriosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Patient assessed efficacy ‐ pain Oral progestagens vs other treatment | no estimate extracted | 2 studies · 286 participants | Moderate Downgraded: risk of bias |
Objective efficacy at end of Oral progestagens vs other treatment | no estimate extracted | 2 studies · 302 participants | Moderate Downgraded: risk of bias |
Side effects ‐ headache Oral progestagens vs other treatment | OR 0.58 [0.38, 0.87] | 3 studies · 613 participants | Moderate Downgraded: risk of bias |
Side effects ‐ hot flushes Oral progestagens vs other treatment | OR 0.49 [0.31, 0.76] | 3 studies · 613 participants | Low Downgraded: risk of bias |
Side effects ‐ genital bleeding Oral progestagens vs other treatment | OR 4.69 [2.47, 8.9] | 1 study · 271 participants | Low Downgraded: imprecision |
Side effects ‐ amenorrhoea Oral progestagens vs other treatment | OR 4.95 [2.88, 8.52] | 1 study · 252 participants | Very low Downgraded: imprecision |
Sleep disorder Oral progestagens vs other treatment | OR 0.19 [0.04, 0.9] | 1 study · 252 participants | Very low Downgraded: imprecision |
Anti‐progestagen compared to other treatment for pain associated with endometriosis
Population: patients with pain associated with endometriosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Patient assessed efficacy none or mild painful periods (dysmenorrhoea) Anti‐progestagen vs other treatment | OR 1.03 [0.55, 1.93] | 2 studies · 176 participants | Low Downgraded: risk of bias |
Objective assessment of efficacy at end of treatment (6 months) ‐ rAFS scores Anti‐progestagen vs other treatment | no estimate extracted | 1 study · 16 participants | Very low Downgraded: risk of bias, imprecision |
Patient assessed efficacy painful periods visual analogue scale Anti‐progestagen vs other treatment | no estimate extracted | 1 study · 55 participants | Moderate |
Side effects ‐ seborrhoea Anti‐progestagen vs other treatment | OR 2.74 [1.69, 4.46] | 3 studies · 357 participants | Low Downgraded: risk of bias |
Side effects ‐ hirsutism Anti‐progestagen vs other treatment | OR 2.63 [1.6, 4.32] | 2 studies · 302 participants | Very low Downgraded: risk of bias |
Side effects ‐ hot flushes Anti‐progestagen vs other treatment | OR 0.65 [0.42, 0.99] | 3 studies · 357 participants | Very low Downgraded: risk of bias |
Side effects ‐ amenorrhoea Anti‐progestagen vs other treatment | OR 0.04 [0.01, 0.38] | 1 study · 49 participants | Low Downgraded: imprecision |