Abstract
Introduction: Sexual dysfunction is common in patients with endometriosis and in the majority of cases the cause of sexual dysfunction is pain. The aim of this study was to investigate the effect of a combination of vaginal gestrinone with oral pinus pinaster extract and resveratrol on the pain scores of patients with deep endometriosis refractory to previous hormone treatment. Methods: Fifteen patients were treated with a combination of 5 mg of vaginal gestrinone in Pentravan® (Fagron, the Netherlands) three times a week and 100 mg of oral pinus pinaster extract (Fagron, the Netherlands) together with 30 mg of resveratrol (Fagron, the Netherlands) daily. Results: Mean pain score was 9 prior to treatment, reducing significantly to 3 (p=0.03) and 0.5 (p=0.004) after 1 and 2 months of treatment, respectively. After six months, all patients were pain-free. Amenorrhea rates were 80% after the first month, reaching 100% during the remainder of the treatment. There were no statistically significant changes in blood chemistry except for SHBG levels, which decreased significantly. Conclusion: This preliminary observational study showed that the combined treatment of vaginal gestrinone with natural antioxidants is very effective for the treatment of refractory pain in patients with deep endometriosis.
Highlights
Sexual dysfunction is common in patients with endometriosis and in the majority of cases the cause of sexual dysfunction is pain
Sexual dysfunction is rather common in endometriosis, affecting almost 61% of patients
Fifteen patients with deep endometriosis and severe pain refractory to previous hormone treatment were enrolled for this small pilot study to evaluate the efficacy of the combined treatment of vaginal gestrinone in Pentravan® with oral pinus pinaster extract and resveratrol
Summary
Sexual dysfunction is common in patients with endometriosis and in the majority of cases the cause of sexual dysfunction is pain. In 58% of these cases, the cause is the presence of pelvic pain, in healthy women this is a rarely a cause of sexual dysfunction, being reported by only 1% of patients [1]. Pain improvement is a crucial step in the management of sexual dysfunction in endometriosis patients and can be achieved through effective medical treatment. Antiprogesterone and androgenic effects, gestrinone fulfills the expected pharmacological profile of a suitable drug for the treatment of endometriosis-related pain [2]. It is effective when administered by several different routes of administration, including through the vaginal mucosa [2,3]. The vaginal route is associated with fewer side effects compared to the oral route [3]
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