الفهرس 
Review of literatureOnly 14 pages are availabe for public view
 |  | from | 101 |  |  |
| | | from | 101 | | |
Abstract
Endometriosis is characterized by the presence of function in endometrial glands and stroma outside the inner surface of the uterine cavity. The symptoms of endometriosis are not specific, which makes it difficult to depend on, when diagnosing the disease. However dysmenorrhea should direct the attention to the possibility of endometriosis. Other tools that may help in diagnosis include clinical examination, serum markers and imaging investigations. Laparoscopy is considered the gold standard for the diagnosis of endometriosis. Medical treatment includes symptomatic treatment such as NSAIDs and hormonal treatment which act mainly on estrogen suppression. The hormonal treatment includes progesterone, oral contraceptive pills. The decisions involved in any treatment plan are individual. The management should balance the efficacy, cost, safety, and risks of various treatment alternatives.
This study was designed to investigate the efficacy and safety of DNG versus COCPs and EPO for the treatment of endometriosis associated pelvic pain (EAPP) over 12 weeks on a VAS and serum CA125.
In this study 60 women with chronic pelvic pain for >6 months not responding to traditional treatment diagnosed by laparoscopy to have pelvic endometriosis. After approval of Ethics Committee and patient consent, the enrolled women were randomly divided into 3 groups. In 20 women, two mg once daily Dienogest (DNG) were administered orally. In 20 women, once daily COCPs (Yasmin) were administered orally and in 20 women, 1000 mg evening primrose oil (EPO) capsule twice daily was administered orally.
The primary outcome measure was pelvic pain score evaluation before, during and after 12 weeks treatment and serum CA125 evaluation before and after 12 weeks treatment.
EAPP was improved in 4(20%) women that used EPO, in 8 (40%) women used COCPs (Yasmin) and in 10 (50%) women used DNG. There was statistically significant difference among 3 groups in VAS and serum CA125 levels.
The study concluded that: Dienogest at a dose of 2 mg daily for 12 weeks was effective for reducing EAPP so it helps in improving the quality of life in endometriotic women. COCPs are considered as first line therapy and also can be used as contraception. EPO use for EAPP is very beneficial but needs more studies.