Oral contraceptives for dysmenorrhea in adolescent girls: a randomized trial.
OBJECTIVE
To assess whether a low-dose oral contraceptive (OC) is more effective than placebo treatment for dysmenorrhea pain in adolescents.


METHODS
This was a randomized, double-blind, placebo-controlled clinical trial of 76 healthy adolescents aged 19 years or younger reporting moderate or severe dysmenorrhea. Subjects were randomly allocated to receive either an OC (ethinyl estradiol [E2] 20 microg and levonorgestrel 100 microg) or a matching placebo for 3 months. Participants used their usual pain medications as needed during the trial. The main outcome measure was score on the Moos Menstrual Distress Questionnaire (pain subscale) for the third menstrual cycle on treatment. Secondary outcomes included pain intensity (rated 0 to 10), days of any pain, days of severe pain, hours of pain on worst day, and use of pain medications.


RESULTS
The mean Moos Menstrual Distress Questionnaire pain score was lower (less pain) in the OC group than the placebo group (3.1, standard deviation 3.2 compared with 5.8, standard deviation 4.5, P = .004, 95% confidence interval for the difference between means 0.88-4.53). By cycle 3, OC users rated their worst pain as less (mean pain rating 3.7 compared with 5.4, P = .02) and used fewer pain medications than placebo users (mean pain pills used 1.3 compared with 3.7, P = .05). By cycle 3, OC users reported fewer days of any pain, fewer days of severe pain, and fewer hours of pain on the worst pain day than placebo users; however, these differences did not reach statistical significance.


CONCLUSIONS
Among adolescents, a low-dose oral contraceptive relieved dysmenorrhea-associated pain more effectively than placebo.


METHODS
I.
Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York, USA.
Anne Rachel
AR
Davis
Carolyn
C
Westhoff
Katharine
K
O'Connell
Nancy
N
Gallagher
D000293:Adolescent; D016001:Confidence Intervals; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004412:Dysmenorrhea / Q000175:diagnosis* / Q000188:drug therapy*; D019304:Ethinyl Estradiol-Norgestrel Combination / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010147:Pain Measurement; D017060:Patient Satisfaction; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D003277:Contraceptives, Oral, Combined; D019304:Ethinyl Estradiol-Norgestrel Combination