Endometriosis-associated pain scores and biomarkers in users of the etonogestrel-releasing subdermal implant or the 52-mg levonorgestrel-releasing intrauterine system for up to 24 months.

Abstract

Objectives: The aims of the study were to correlate endometriosis-associated pain, evaluated by visual analogue scale (VAS) scores, with serum levels of etonogestrel (ENG), levonorgestrel (LNG), CA-125 and soluble CD23 in users of the ENG implant or the 52-mg LNG-releasing intrauterine system (52 mg LNG-IUS) for up to 2 years after device placement.Methods: A randomised trial was conducted at the University of Campinas Medical School, Brazil. All participants (n = 103) had had endometriosis-associated chronic pelvic pain or dysmenorrhoea, or both, for more than 6 months. Participants were randomly assigned to use an ENG implant (experimental treatment) or a 52-mg LNG-IUS (active comparator). Follow-up was conducted 6 monthly for up to 24 months after device placement. Dysmenorrhoea and chronic pelvic pain were evaluated using a VAS and the scores were correlated with serum levels of ENG, LNG, CA-125 and soluble CD23.Results: Both progestin-only contraceptives significantly reduced VAS scores for dysmenorrhoea and chronic pelvic pain and reduced serum levels of soluble CD23 (p < 0.001). Serum levels of CA-125 decreased only in the ENG implant group after 24 months' use of the device (p < 0.001). No correlation was found between pain scores and ENG or LNG serum levels over time (p > 0.005).Conclusion: Both contraceptives improved dysmenorrhoea and chronic pelvic pain scores in women with endometriosis-associated pain and they reduced serum levels of soluble CD23; however, serum levels of CA-125 were reduced only in ENG implant users over the 24-month study period.

• Authors: Deborah Margatho, Nelsilene Mota Carvalho, Luis Bahamondes
• Journal: The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception (Eur J Contracept Reprod Health Care) Vol. 25 Issue 2 Pg. 133-140 (Apr 2020) ISSN: 1473-0782 [Electronic] England
• PMID: 32069126 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• CA-125 Antigen
• Drug Implants
• etonogestrel
• Levonorgestrel
• Desogestrel

Topics

• Adolescent
• Adult
• Brazil
• CA-125 Antigen (blood)
• Desogestrel (administration & dosage, therapeutic use)
• Drug Implants
• Dysmenorrhea (drug therapy, etiology)
• Endometriosis (complications, drug therapy)
• Female
• Humans
• Intrauterine Devices, Medicated
• Levonorgestrel (administration & dosage, therapeutic use)
• Middle Aged
• Pain Measurement
• Pelvic Pain (drug therapy, etiology)
• Young Adult