title: A randomized controlled trial of medroxyprogesterone acetate and psychotherapy for the treatment of pelvic congestion.
abstract: The value of medroxyprogesterone acetate (MPA) and of psychotherapy in the treatment of lower abdominal pain due to pelvic congestion was assessed in a randomized controlled trial. Eighty-four women with abnormal pelvic venography were assigned to one of four treatment groups: MPA alone, MPA plus psychotherapy, placebo alone, and placebo plus psychotherapy. Women were treated for 4 months and thereafter followed up regularly for 9 months with pain assessments, pelvic ultrasound scanning, and hormone measurements. During treatment, MPA showed a significant benefit in terms of a reduction in visual analogue scale pain score, with 73% of women reporting at least 50% improvement compared with 33% of those treated with placebo. At 9 months after the end of therapy there was no overall significant effect of MPA or psychotherapy, but there was an interaction between MPA and psychotherapy, with 71% of the women in this group showing a greater than or equal to 50% reduction in pain score. Therapy with MPA is a useful first-line therapy for women with pain associated with demonstrable pelvic congestion.
authors.affiliation: St Mary's Hospital Medical School, London, Department of Obstetrics and Gynaecology.
authors.forename: C M
authors.initials: CM
authors.lastname: Farquhar
authors.forename: V
authors.initials: V
authors.lastname: Rogers
authors.forename: S
authors.initials: S
authors.lastname: Franks
authors.forename: S
authors.initials: S
authors.lastname: Pearce
authors.forename: J
authors.initials: J
authors.lastname: Wadsworth
authors.forename: R W
authors.initials: RW
authors.lastname: Beard
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000473:pathology; D004717:Endometrium / Q000473:pathology; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006062:Gonadotropins / Q000097:blood; D006801:Humans; D008525:Medroxyprogesterone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017258:Medroxyprogesterone Acetate; D008598:Menstruation / Q000187:drug effects; D059408:Pain Management; D010147:Pain Measurement; D010349:Patient Compliance; D010388:Pelvis / Q000098:blood supply; D011379:Prognosis; D011613:Psychotherapy; D016032:Randomized Controlled Trials as Topic
chemical_list: D012739:Gonadal Steroid Hormones; D006062:Gonadotropins; D017258:Medroxyprogesterone Acetate; D008525:Medroxyprogesterone