title: Continuous versus cyclic use of oral contraceptives after surgery for symptomatic endometriosis: a prospective cohort study.
abstract: OBJECTIVE
  To evaluate the efficacy of continuous oral contraceptive (OC) use versus the usual cyclic fashion in the recurrence of endometriosis-related symptoms after surgery.
  
  
  METHODS
  Prospective cohort trial involving patients in two tertiary care units.
  
  
  METHODS
  Academic institution in collaboration with a private hospital.
  
  
  METHODS
  356 patients underwent surgical treatment by laparoscopy for symptomatic endometriosis.
  
  
  METHODS
  After surgical treatment for endometriosis, patients offered 6-month course of cyclic OC (including a 7-day pill-free period) or continuous OC.
  
  
  METHODS
  Recurrence rate of endometriosis-related symptoms and endometriomas after fertility-sparing surgery.
  
  
  RESULTS
  Out of 356 patients, 167 were placed on the usual cyclic OC course and 85 on continuous OC for a minimum of 6 months. The continuous OC group experienced a statistically significant reduction in recurrence rates for endometrioma, dysmenorrhea, and non-menstrual pelvic pain as compared with the cyclic OC group. There was no reduction in the recurrence of dyspareunia between the two groups.
  
  
  CONCLUSIONS
  After surgical treatment of endometriosis, the use of both cyclic and continuous OC improves pain symptoms when compared with preoperative scores. Continuous OC appears to be associated with a reduced recurrence rate for dysmenorrhea, non-menstrual pelvic pain, and endometrioma but not for dyspareunia as compared with cyclic OC.
authors: 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Athens, Greece.
authors: Nikos
authors: N
authors: Vlahos
authors: Athanasios
authors: A
authors: Vlachos
authors: Olga
authors: O
authors: Triantafyllidou
authors: Nikolaos
authors: N
authors: Vitoratos
authors: George
authors: G
authors: Creatsas
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage*; D003279:Contraceptives, Oral, Sequential / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004412:Dysmenorrhea / Q000209:etiology / Q000517:prevention & control; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D059247:Fertility Preservation / Q000009:adverse effects; D006115:Greece; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D017699:Pelvic Pain / Q000209:etiology / Q000517:prevention & control; D011182:Postoperative Care; D011446:Prospective Studies; D012008:Recurrence; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003278:Contraceptives, Oral, Hormonal; D003279:Contraceptives, Oral, Sequential
keywords: Drosperinone; dysmenorrhea; endometriosis; laparoscopy; non-menstrual pelvic pain; oral contraceptives