Data_Sheet_1_Effect and safety of drospirenone and ethinylestradiol tablets (II) for dysmenorrhea: A systematic review and meta-analysis.pdf

AimThis systematic review aimed to assess the efficacy and safety of Drospirenone and Ethinylestradiol Tablets (II) in the treatment of dysmenorrhea.MethodsElectronic databases, namely PubMed, Embase, Cochrane Controlled Register of Trials (CENTRAL), Scopus, Science, CBM, CNKI, Wanfang, and VIP, were searched before September 2022. Randomized controlled trials (RCTs), non-randomized controlled trials, cohort studies, case-control studies, and single-arm studies were included. Furthermore, the Cochrane Risk of Bias Tool for Systematic Reviews version 1 was used for the risk of bias assessment on RCTs. The Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool was used for risk of bias assessment on non-randomized studies. The risk ratio (RR) was calculated for dichotomous data. Mean difference (MD) or standardized MD (SMD) were used as the effect size for continuous data.ResultsA total of 11 studies involving 2,251 participants with dysmenorrhea were included. When Drospirenone and Ethinylestradiol Tablets (II) conventional 24/4-day regimen was compared with placebo, the total efficiency rate (defined as pain symptom disappearing or being relieved) in Drospirenone and Ethinylestradiol Tablets (II) 24/4-day regimen group was higher than in placebo group (RR = 5.55, 95%CI: 2.48–12.39, P 0.05).ConclusionDrospirenone and Ethinylestradiol Tablets (II) could improve symptoms of dysmenorrhea and decrease other related pain symptoms. More high-quality evidence is needed to confirm the advantages.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021271605], identifier [CRD42021271605].</p

Застосування дієногесту при ендометріозі. Огляд описової літератури та коментарі експертів

Objective: Endometriosis affects up to 10% of women of reproductive age, and the main goal of treatment is to relieve symptoms. Progestins have been the mainstay of endometriosis suppression, of which dienogest has become an important option in many parts of the world. This is an expert literature review, with recommendations on the use of dienogest in the context of various clinical considerations when treating endometriosis.Methods: A search of PubMed was conducted for papers published between 2007 and 2019 on the use of dienogest in endometriosis. Experts reviewed these and included those they considered most relevant in clinical practice, according to their own clinical experience.Results: Evidence regarding the long-term use (&gt;15 months) of dienogest for the management of endometriosis is presented, with experts concluding that the efficacy of dienogest should be assessed primarily on its impact on pain and quality of life. Fertility preservation, the option to avoid or delay surgery, and managing bleeding irregularities that can occur with this treatment are also considered. Counseling women on potential bleeding risks before starting treatment may be helpful, and evidence suggests that few women discontinue treatment for this reason, with the benefits of treatment outweighing any impact of bleeding irregularities.Conclusions: Overall, the evidence demonstrates that dienogest offers an effective and tolerable alternative or adjunct to surgery and provides many advantages over combined hormonal contraceptives for the treatment of endometriosis. It is important that treatment guidelines are followed and care is tailored to the woman’s individual needs and desires.Цель. Эндометриоз поражает до 10% женщин репродуктивного возраста, и главная цель лечения – облегчить его симптомы. Прогестины являются основными средствами для подавления проявлений эндометриоза, важным представителем которых во многих странах мира стал диеногест. Данная статья является экспертным обзором литературы с рекомендациями по использованию диеногеста в лечении эндометриоза в контексте различных клинических соображений.Методы. В базе данных PubMed проведен поиск публикаций, посвященных использованию диеногеста при эндометриозе, которые вышли между 2007 и 2019 годами. Эксперты рассмотрели их и включили наиболее актуальные для клинической практики, основываясь на собственном клиническом опыте.Результаты. Приведены доказательства длительного (более 15 месяцев) применения диеногеста для лечения эндометриоза, при этом эксперты делают вывод, что эффективность диеногеста следует оценивать прежде всего на основе его влияния на боль и качество жизни пациентки. Кроме того, рассмотрена возможность сохранить фертильность, избежать или отсрочить хирургическое вмешательство, а также тактика ведения нерегулярных кровотечений, которые могут возникнуть при этом лечении. Может быть полезным консультирование женщин перед началом терапии насчет возможных рисков развития кровотечения. Как свидетельствуют данные исследований, мало женщин прекращает лечение по этой причине, при этом преимущества терапии превалируют над каким-либо воздействием нерегулярных кровотечений.Выводы. В целом имеющиеся доказательства свидетельствуют о том, что диеногест хорошо переносится и является эффективной альтернативой хирургическому лечению или дополнением к хирургическому вмешательству, имея много преимуществ перед комбинированными гормональными контрацептивами в терапии эндометриоза. Важно соблюдать руководящие принципы лечения и учитывать индивидуальные потребности и пожелания женщины.Мета. Ендометріоз вражає до 10% жінок репродуктивного віку, і головна мета лікування – полегшити його симптоми. Прогестини є основними засобами для пригнічення проявів ендометріозу, важливим представником яких в багатьох країнах світу став дієногест. Дана стаття є експертним оглядом літератури з рекомендаціями щодо застосування дієногесту в лікуванні ендометріозу в контексті різних клінічних міркувань.Методи. У базі даних PubMed проведений пошук публікацій, присвячених застосуванню дієногесту при ендометріозі, які вийшли між 2007 та 2019 роками. Експерти розглянули їх та включили найбільш актуальні для клінічної практики, базуючись на власному клінічному досвіді.Результати. Наведені докази щодо тривалого (понад 15 місяців) застосування дієногесту для лікування ендометріозу, при цьому експерти роблять висновок, що ефективність дієногесту слід оцінювати насамперед на основі його впливу на біль та якість життя пацієнтки. Крім того, розглянуто можливість збереження фертильності, можливість уникнення або відтермінування хірургічного втручання, а також тактика ведення нерегулярних кровотеч, які можуть виникнути під час лікування. Може бути корисним консультування жінок перед початком лікування щодо ймовірних ризиків розвитку кровотечі. Як свідчать дані досліджень, мало жінок припиняють лікування з цієї причини, при цьому переваги лікування превалюють над будь-яким впливом нерегулярних кровотеч.Висновки. Загалом наявні докази свідчать про те, що дієногест добре переноситься і є ефективною альтернативою хірургічному лікуванню або доповненням до хірургічного втручання, маючи багато переваг перед комбінованими гормональними контрацептивами в терапії ендометріозу. Важливо дотримуватися керівних принципів лікування та враховувати індивідуальні потреби і побажання жінки

A review of the risk factors, genetics and treatment of endometriosis in Chinese women: a comparative update

Abstract Endometriosis is one of the major causes of economic burden and compromised quality of life in a very large percentage of Asian women. While it is perceived as a benign condition, recent research has shown that it may be a significant cause of infertility and metastatic cancer. It has also been associated with other diseases linked to the functioning of the immune system. Genetic as well as environmental factors are known to affect the manifestation and progression of endometriosis. This review aims to summarize recent research pertaining to the risk factors, diagnosis and treatment of endometriosis in Chinese women. It also provides an overview of identified genetic mutations and polymorphisms and their effects on the risk of developing endometriosis in the Chinese population. A comparison has been drawn between Asian and European-American female populations and the differences in risk factors and treatment responses have been summarized. Since traditional Chinese medicine (TCM) is often used to treat endometriosis, wherever possible, a comparison between efficacies of Western medicine and TCM in the Chinese population has also been provided. Although much progress has been made in the treatment and resolution of endometriosis, several gaps remain and this review also highlights possible areas of future research and advancement that can result in an improvement in patient outcomes and quality of life

Use of dienogest in endometriosis: a narrative literature review and expert commentary.

Objective: Endometriosis affects up to 10% of women of reproductive age, and the main goal of treatment is to relieve symptoms. Progestins have been the mainstay of endometriosis suppression, of which dienogest has become an important option in many parts of the world. This is an expert literature review, with recommendations on the use of dienogest in the context of various clinical considerations when treating endometriosis.Methods: A search of PubMed was conducted for papers published between 2007 and 2019 on the use of dienogest in endometriosis. Experts reviewed these and included those they considered most relevant in clinical practice, according to their own clinical experience.Results: Evidence regarding the long-term use (>15 months) of dienogest for the management of endometriosis is presented, with experts concluding that the efficacy of dienogest should be assessed primarily on its impact on pain and quality of life. Fertility preservation, the option to avoid or delay surgery, and managing bleeding irregularities that can occur with this treatment are also considered. Counseling women on potential bleeding risks before starting treatment may be helpful, and evidence suggests that few women discontinue treatment for this reason, with the benefits of treatment outweighing any impact of bleeding irregularities.Conclusions: Overall, the evidence demonstrates that dienogest offers an effective and tolerable alternative or adjunct to surgery and provides many advantages over combined hormonal contraceptives for the treatment of endometriosis. It is important that treatment guidelines are followed and care is tailored to the woman's individual needs and desires

Comparative study of endometrioid borderline ovarian tumor with and without endometriosis

Abstract Background Synchronous endometriosis has been poorly studied in women with endometrioid borderline ovarian tumors (EBOTs). The aims of this study were to compare the clinicopathological features and prognosis of EBOTs with or without endometriosis. Results Of 52 patients diagnosed with EBOTs, no death was observed and only one case had successful pregnancy during the follow-up period. Older, menopausal EBOT patients, EBOT patients with small tumors and relatively low CA125 level probably had better progression-free survival (PFS) outcomes. About 1/3 of EBOTs had concomitant endometrial lesions. Approximately 1/3 of EBOTs were associated with endometriosis. Patients were divided into two groups according to the presence or not of endometriosis in this retrospective cohort study. Patients with endometriosis-associated endometrioid borderline ovarian tumor (EAEBOT) were more likely to be younger and premenopausal. Variables such as PFS outcomes, endometrial lesions did not differ statistically between groups. However, in specific EBOT patients like parous patients, patients with CA125 ≥ 140 U/ml or patients without fertility sparing surgery, coexisting endometriosis perhaps predicted worse PFS outcomes. Conclusion We considered EAEBOT as an entity similar to non-EAEBOT. Closely follow-up for some particular patients with concomitant endometriosis was necessary

Factors associated with deep infiltrating endometriosis versus ovarian endometrioma in China: a subgroup analysis from the FEELING study

Abstract Background To compare potential factors associated with deep infiltrating endometriosis (DIE) versus ovarian endometrioma (OMA) among endometriosis patients in China. Methods A subgroup analysis of factors associated with DIE versus OMA was performed in Chinese women from the FEELING study. This study included 156 OMA patients and 78 DIE patients. Retrospective information on symptoms and previous medical history was collected via face-to-face interviews; patients also completed a questionnaire to provide information on current habits. Univariate and multivariate logistic regression analyses were conducted to identify potential factors that are associated with DIE versus OMA. Results From univariate analysis, women who were married, at older age, had any siblings, prior pregnancy, or longer time since age at menarche on the day of visit were more likely to be diagnosed with DIE (P < 0.05). Also, the incidence of previous uterine surgery, menstrual and ovulatory disorders, deep dyspareunia, and gastrointestinal symptoms during menstruation were major factors that were significantly associated with the diagnosis of DIE (P < 0.05). Multivariate analysis showed that women with any siblings, gastrointestinal symptoms during menstruation, or eating a greater number of fruit/vegetables per day were more likely to be diagnosed with DIE. Meanwhile, eating organic food and experiencing stress were major factors that are associated with the diagnosis of OMA. Conclusions The findings provide additional information on the potential risk factors that are associated with DIE, compared with OMA among Chinese endometriosis patients. The results may help to better understand DIE versus OMA, and aid in earlier risk stratification and diagnosis of the patients. Trial registration NCT01351051. Registered 10 May 2011

Effects of localization of uterine adenomyosis on clinical features and pregnancy outcome

Abstract The purpose of this study was to implore the association among clinical features, long-term fertility outcomes and the anatomical location of adenomyosis identified by ultrasound. We collected data of non-pregnant patients between 20 and 40 years old who had undergone surgical exploration for benign gynecological conditions at our institution between January 2010 and December 2017. A total of 158 women met the inclusion criteria and were allocated into three groups according to the ultrasound-determined adenomyosis anatomical location: anterior (Group A), posterior (Group B), both posterior and anterior (Group C). 44.3% (70/158) adenomyosis was located at the posterior side. History of miscarriage and parity were significantly higher in Group C (p = 0.036 and 0.001 respectively). Group C also had a higher concurrence rate of ovarian endometrioma (OEM) (80.4%, p = 0.002), pelvic adhesion (80.4%, P = 0.003) and the revised American Fertility Society (rAFS) Score (median64, range2-100, P  0.05). During the follow-up, 59.2% (61/103) patients had clinical pregnancies, and 26.2% (16/61) of them experienced pregnancy loss. Total in vitro fertilization and embryo transfer pregnancy rate was 64.6% (42/65) and spontaneous pregnancy rate was 50.0% (19/38). The Kaplan–Meier curves demonstrated significant lower cumulative pregnancy rate in Group C than Group A and Group B (p = 0.01). Severe obstetric complications such as placenta previa, placenta accreta, preeclampsia, and preterm birth were only found in women with adenomyosis located in the posterior side. In conclusion, types of adenomyosis based on sonographic location had different clinical features and pregnancy outcome. Patients with adenomyosis lesion in both anterior and posterior sides had higher combination of OEM, pelvic adhesion and rAFS score