Abstract
PurposeEndometriosis is a common, chronic gynecological disease that affects women’s fertility potential. Dydrogesterone is an effective and safe drug that is under-utilized due to limited clinical research. The purpose of this evidence mapping is to identify, describe, and analyze the current available evidence regarding dydrogesterone for the treatment of endometriosis.Materials and methodsWe performed a search in electronic databases: Medline, The Cochrane Library, EMBASE, PubMed, CNKI, Wanfang, VIP, and CBM. We also hand-searched google for relevant studies. Our primary outcomes included changes in pain relief including pelvic pain, dysmenorrhea, and dyspareunia. Secondary outcomes included pregnancy rate, frequency of analgesic use, and other reported outcomes according to specific settings in the studies.ResultsOf 377 references screened, 19 studies were included in the data synthesis involving 1709 female participants. Nearly three-quarters were either randomized control trials or clinical control trials. Compared with gestrinone, dydrogesterone relieved dysmenorrhea, increased the pregnancy rate, and reduced the risk of certain adverse events. Compared with GnRH-a, dydrogesterone also lowered the risk of endometriosis recurrence and elevated transaminase levels. Whether there was any difference in efficacy between dydrogesterone and leuprolide acetate, letrozole or traditional Chinese medicine remains unclear due to insufficient data.ConclusionsThe amount and quality of evidence evaluating the effects of dydrogesterone for the treatment of endometriosis is generally very low. Limited evidence suggests that dydrogesterone may have some advantages over gestrinone, GnRH agonists, and other therapeutic interventions in treating endometriosis. However, this conclusion should be interpreted with caution.
Highlights
Endometriosis, defined as the presence of endometrial-like tissue outside the uterus, is a complex and chronic gynecological disease that affects women’s fertility potential [1]
Avoid scientific redundancies, and identify research gaps, we provide a mapping of the empirical literature on the effects of dydrogesterone in the treatment of endometriosis
The remaining 12 studies were rated as low risk of bias. Eleven studies of these 12 studies reported no withdraw during treatment and 1 of these 12 studies reported less than 10% drop-out rate
Summary
Endometriosis, defined as the presence of endometrial-like tissue outside the uterus, is a complex and chronic gynecological disease that affects women’s fertility potential [1]. The prevalence of endometriosis has been estimated to be between 2 and 10% for women of reproductive age, and between 25 and 50% for women with infertility [2, 3]. Patients with endometriosis may be asymptomatic, most patients usually present with one or more associated symptoms, including dysmenorrhea, chronic pelvic pain, deep dyspareunia, cyclical intestinal complaints, fatigue/ weariness, and infertility [1]. Endometriosis-associated symptoms progressively impair the ability of women to carry out certain daily activities and result in worsening health status and overall well-being [4].
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